Fast Five Quiz: Anemia in Myelodysplastic Syndrome

Emmanuel C. Besa, MD


May 12, 2021

Figure 1. Myelodysplastic anemia.

Erythropoiesis-stimulating agents (ESAs), specifically epoetin alfa, are recommended as first-line therapy for the treatment of symptomatic anemia in patients with MDS.

Granulocyte colony-stimulating factor (G-CSF) is recommended as second-line therapy for patients who do not respond to erythropoiesis-stimulating agents. Although G-CSF is not approved by the US Food and Drug Administration for patients with anemia of MDS, a 2021 update on MDS indicates that ESA with or without G-CSF is not contraindicated in most patients with low-risk MDS with significant anemia without other cytopenias.

Immunosuppressive therapy remains an area of controversy but is a treatment option for younger patients with a serum erythropoietin level greater than 500 mU/mL who have an autoimmune component to their disease. Red blood cell transfusions are only recommended for patients with moderate to severe anemia.

Learn more about erythropoiesis-stimulating agents.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: