Treatment with growth factors, particularly erythropoietin (EPO) alone or in association with granulocyte colony-stimulating factor (G-CSF), has been useful in the management of anemia in low-risk patients with myelodysplastic syndromes (refractory anemia, refractory anemia with ringed sideroblasts, low or intermediate-1 IPSS groups). Two pre-treatment variables (serum EPO levels and red blood cell-transfusion needs) can predict erythroid responses to these high cost treatments. The indiscriminate use of G-CSF in neutropenic patients is not recommended although it can be useful in specific situations.
Myelodysplastic syndromes; anemia; erythropoietin; colony-stimulating factor; G-CSF