Myelodysplastic syndromes (MDS) are hematopoietic stem cell malignancies associated with an erythroid maturation defect, resulting in anemia. Treatments for MDS include erythropoiesis-stimulating agents (ESAs). The identification of prognostic markers is important to help predict response and improve outcomes. Various scoring systems have been developed to help predict response to ESAs. Despite limitations in its assessment, serum erythropoietin (sEPO) level is an important predictor of hematologic response to ESAs in patients with lower-risk MDS. Numerous studies have reported significantly lower sEPO levels among responders versus non-responders. Furthermore, treatment response is significantly more likely among those with sEPO levels below versus those above various cutoffs. Other prognostic indicators for response to ESAs include lower transfusion requirement, fewer bone marrow blasts, higher hemoglobin, lower serum ferritin, lower-risk MDS, and more normal cytogenetics. Studies of other MDS therapies (e.g., lenalidomide and luspatercept) have also reported that lower sEPO levels are indicative of hematologic response. In addition, lower sEPO levels (up to 500 IU/L) have been included in treatment algorithms for patients with lower-risk MDS to define whether ESAs are indicated. Lower sEPO levels are predictive of hematologic response-particularly to ESAs. Further, clinical trials should use sEPO thresholds to ensure more homogeneous cohorts.

中文翻译：

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血清促红细胞生成素在低危骨髓增生异常综合症患者中的预后价值：文献综述和专家意见。

骨髓增生异常综合症（MDS）是与红细胞成熟缺陷相关的造血干细胞恶性肿瘤，导致贫血。MDS的治疗方法包括促红细胞生成剂（ESA）。预后标志物的鉴定对于帮助预测反应和改善预后至关重要。已经开发了各种评分系统来帮助预测对ESA的响应。尽管评估存在局限性，但低危MDS患者的血清促红细胞生成素（sEPO）水平仍是血液对ESA血液学反应的重要预测指标。大量研究表明，响应者与未响应者的sEPO水平明显降低。此外，sEPO水平低于各种临界值的患者中，治疗反应的可能性更大。对ESA应答的其他预后指标包括更低的输血需求，更少的骨髓母细胞，更高的血红蛋白，更低的血清铁蛋白，更低的MDS风险以及更多的正常细胞遗传学。其他MDS治疗方法（例如来那度胺和luspatercept）的研究也报告了较低的sEPO水平可指示血液学反应。此外，对于患有低危MDS的患者，治疗算法中应包括较低的sEPO水平（最高500 IU / L），以定义是否需要使用ESA。较低的sEPO水平可预测血液学反应-特别是对ESA的血液学反应。此外，临床试验应使用sEPO阈值以确保更均匀的队列。来那度胺和luspatercept）也报告了较低的sEPO水平指示血液学反应。此外，对于患有低危MDS的患者，治疗算法中应包括较低的sEPO水平（最高500 IU / L），以定义是否需要使用ESA。较低的sEPO水平可预测血液学反应-特别是对ESA的血液学反应。此外，临床试验应使用sEPO阈值以确保更均匀的队列。来那度胺和luspatercept）也报告了较低的sEPO水平指示血液学反应。此外，对于患有低危MDS的患者，治疗算法中应包括较低的sEPO水平（最高500 IU / L），以定义是否需要使用ESA。较低的sEPO水平可预测血液学反应-特别是对ESA的血液学反应。此外，临床试验应使用sEPO阈值以确保更均匀的队列。