The validated Nordic scoring system showed that LR-MDS patients with serum erythropoietin (EPO) < 100 U/L and a transfusion requirement of <2 packed red blood cells per month have a greater than 70% probability of responding to ESA, unlike those with EPO > 500 U/L that have an estimated response rate of less than 10% [6]. This evidence concerns the gene EPO and myelodysplastic syndrome.