74- year-old man with LRMDS and Transfusion Dependent Anemia

Clinical Presentation: 74-year-old man diagnosed 1 years ago with LR-MDS with moderate anemia (Hb 11.2 g/dL) Non-del(5q)

• No family history of cancer or significant genotoxic agent exposure

• Serum EPO - 250m U/L, Ring sideroblast (RS) positive • IPSS-R: Low

• Received 2 units of blood every 2 months for 4 months; at that point they started therapy with ESAs.

• At 12 weeks, Hb remained essentially the same (11.4 g/dL) and transfusion needs decreased.

• At 20 weeks, his Hb is now 10.8 g/dL and he now is requiring 2-3 units of blood every month.