Serum Erythropoietin in Myelodysplastic Syndromes

The myelodyspiastic syndromes (MDS) are a group of clonal hematological disorders characterized by a highly ineffective hemopoiesis affecting all bone marrow lineages. They are commonly defined according to the French-American-British (FAB) classification [l].The most common feature of these syndromes is an anemia of varying degree, which is unresponsive to common hematinics, thus defined as refractory anemia. Laboratory studies have shown poor erythroid progenitor growth in culture [2], low reticulocyte counts in relation to hematocrit, and highly ineffective erythropoiesis when ferrokinetic studies were performed [3].The recent availability of immunoassays for erythropoietin (Epo) has made possible the measurement of its serum levels in many clinical conditions characterized by anemia.This has led to the interesting observation that, besides the expected low levels unrelated to the degree of anemia that are observed in chronic renal failure, Epo levels were also lower than expected in diseases such as sickle cell disease [4], rheumathoid arthritis [5,6], cancer [7], multiple myeloma [8], and AIDS [9].