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How would you approach transfusion-dependent anemia in an intermediate-risk MDS patient refractory to azacitidine?
The patient has ESRD. EPO level is >500 and does not have del5q or actionable mutations on NGS. Is there a benefit to switching to an alternative HMA?
Answer from: Medical Oncologist at Academic Institution
An MDS patient with ESRD likely has multiple contributors to their anemia. It is surprising to see the EPO level >500, but this may reflect the use of ESAs. If so, I would make sure that the dose is appropriate for MDS (60,000 units at least weekly) and that it is not renally dosed. If the patien...
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