Erythropoiesis-stimulating agents (ESAs), such as darbepoetin-α and epoetin-α, are the guideline-recommended, first-line standard-of-care for the treatment of symptomatic anemia in patients with LR-MDS and serum erythropoietin (EPO) ≤ 500 U/L [8, 11, 12]. Here, EPO is linked to anemia.