The MDSs are clonal disorders with dysplasia of at least 1 myeloid cell line, indolent disease courses, peripheral blood cytopenia, and a propensity to eventually progress into acute myeloid leukemia.[9,10] The erythropoiesis stimulating agents, including recombinant humanized erythropoietin, are used to improve anemia state in 15% to 40% of patients with lower-risk MDS.[11] There are a series of cases reporting that MDS occurs in combination with solid tumors. Here, EPO is linked to anemia.