Fast Five Quiz: Anemia in Myelodysplastic Syndrome

Emmanuel C. Besa, MD

Disclosures

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.

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