MDS patients with low-INT1 IPSS risk, hemoglobin levels lower than 10 g/dl, and serum erythropoietin levels <500 mIU/ml should be treated according to current guidelines with high dose ESAs, as fixed weekly subcutaneous doses of 60–80,000U α- or β-erythropoietin or 300 μg darbepoetin.4,5. Here, EPO is linked to myelodysplastic syndrome.