EPO and plasma cell myeloma: MM-associated anemia is caused by various mechanisms, including cytokine-induced apoptosis of red blood cells secreted by myeloma cells, erythroblastic island destruction leading to decreased red blood cell production, insufficient erythropoietin production due to renal impairment, impaired response to erythropoietin due to marrow replacement by plasma cells, and impaired utilization of stored iron [48–50].