Skill Checkup: A 72-Year-Old Woman With Myelodysplastic Syndrome Presents With Persistent Anemia and Fatigue

Emmanuel C. Besa, MD

April 08, 2022

Features predictive of ESA response include a lower baseline serum EPO level (< 500 IU/mL), a low transfusion burden (< 2 units a month), a fixed-dose regimen, shorter time from diagnosis to starting treatment, and diagnosis of refractory anemia or RARS. Although the patient in the present case is in fact diagnosed with refractory anemia or RARS, response rates to ESA therapy are variable in patients with lower-risk MDS, ranging from 30%-60%.

In this patient population, close monitoring of hemoglobin level is recommended to avoid increases to > 12 g/dL (associated with a risk for systemic hypertension and thrombosis). In addition, immunomodulatory agent lenalidomide can reduce transfusion requirements in lower-risk MDS patients with a normal karyotype.

1 2 3 4 5 6

Next Section

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Emmanuel C. Besa. Skill Checkup: A 72-Year-Old Woman With Myelodysplastic Syndrome Presents With Persistent Anemia and Fatigue - Medscape - Apr 08, 2022.

Comments

Commenting is limited to medical professionals. To comment please Log-in.

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.