Combination therapy with a short-acting erythropoiesis-stimulating agent and epoetin beta pegol eliminated the need for blood transfusions in a hemodialysis patient with myelodysplastic syndrome

Abstract

A 67-year-old female had been on dialysis for 4 years. She had been started on hemodialysis at another hospital for end-stage renal failure due to diabetic nephropathy. In May 2014, she developed pancytopenia, and in June of that year she was diagnosed with myelodysplastic syndrome (MDS) on the basis of bone marrow aspiration. As the anemia progressed, the dose of the short-acting erythropoiesis-stimulating agent (ESA) that she was being treated with was increased; however, the patient continued to require frequent blood transfusions. When low-dose epoetin beta pegol (a continuous erythropoietin receptor activator, CERA) was added to the short-acting ESA in December of that year, her anemia improved markedly, and eventually, blood transfusions were not required. The concomitant administration of a short-acting ESA and low-dose CERA therapy eliminated the need for blood transfusions in a maintenance hemodialysis patient with MDS.