Zoledronic Acid Treatment in Patients With Congenital Dyserythropoietic Anemia

Inclusion Criteria: * Age ≥ 18 years, regardless of gender. * Diagnosis of Congenital Dyserythropoietic Anemia (CDA) based on clinical presentation, laboratory tests, and family investigation, with the presence of RBM28 mutation and/or increased vacuolization within nucleated red blood cells under light microscopy of bone marrow. * Presence of anemia (Hemoglobin \< 100 g/L at screening) or transfusion dependence (defined as an average transfusion interval of \< 8 weeks within the past 3 months). * Performance status is acceptable (ECOG score 0-2). * Normal renal function (estimated glomerular filtration rate, eGFR ≥ 60 mL/min/1.73m²). * Serum calcium levels within the normal range. * Female patients of childbearing potential must have a negative pregnancy test before enrollment and agree to use effective contraception during the study and for 3 months after completion. * The patient and/or guardian voluntarily sign the informed consent form. Exclusion Criteria: * Known hypersensitivity to bisphosphonates or any of their excipients. * Severe periodontal disease or a recent history (within 6 months) of osteonecrosis of the jaw. * Hypocalcemia. * Pregnant or lactating women. * Currently receiving other experimental drug treatments that may affect erythropoiesis (e.g., Luspatercept). * Active, uncontrolled systemic infection. * Severe cardiac, pulmonary, or hepatic dysfunction, as judged by the investigator to be unsuitable for participation in the study