Early introduction of ESA in low risk MDS patients may delay the need for RBC transfusion: A retrospective analysis on 112 patients

Abstract ESAs are increasingly used to treat anemia of lower risk MDS, even before RBC transfusion requirement. From a previously published patient cohort treated with ESAs, we selected 112 patients with de novo low or int-1 IPSS MDS with Hb < 10 g/dl, serum EPO < 500 UI/l and who had never been transfused. Erythroid response rate at 12 weeks was 63.1% (IWG 2006). In multivariate analysis, an interval between diagnosis and ESA onset < 6 months, Hb level > 9 g/dl, and serum EPO < 100 UI/l predicted better response to ESA while shorter interval between diagnosis and ESA onset ( p = 0.01), lower serum EPO ( p = 0.04) and WHO diagnosis of RCMD-RS ( p = 0.03) were associated with longer response. Median interval from diagnosis to transfusion dependency was 80 months and 35 months, respectively, in patients with onset of ESA