NCCN Guidelines for Patients® | Myelodysplastic Syndromes
17 NCCN Guidelines for Patients ® : Myelodysplastic Syndromes, 2018 2 Testing for MDS Blood tests Serum EPO EPO is a substance that tells (stimulates) the bone marrow to make more red blood cells. The body normally makes more EPO in response to low levels of oxygen, which is carried in red blood cells. Measuring the amount of EPO in the blood can help find out the cause of anemia. The amount of EPO in the blood is called serum EPO. The serum EPO level is measured in mU/mL ( m illi u nits per m illi l iter). A low level of EPO can cause anemia and may be a sign of a health problem other than MDS. A low level of EPO can also make anemia worse in a person with MDS. Iron, ferritin, folate, and vitamin B12 Iron is a mineral that the body needs to make red blood cells. Iron is an important part of hemoglobin— the protein in red blood cells that carries oxygen. Ferritin is a protein that binds to iron and stores it for use in the body. The amount of ferritin in the blood reflects the amount of iron stored in the body. Folate and vitamin B12 are other nutrients in the body that are needed to make red blood cells. A shortage of any one of these substances can cause anemia. A shortage of folate or vitamin B12 can also cause red blood cells to have an abnormal shape, size, or look. Assess for thyroid problems The thyroid makes hormones that help control how fast the body uses energy. The hormones also affect other body functions. An underactive thyroid—when it isn’t making enough hormones—can lead to anemia. Thus, a test of the amount of TSH ( t hyroid- s timulating h ormone) in the blood may be used to check how well the thyroid is working. A high level of TSH in the blood can be a sign that the thyroid isn’t making enough hormones. Copper level Copper is a mineral that helps with many processes in the body. A low level of copper can cause the number of red blood cells and white blood cells to be low. It can also cause blood cells to have an abnormal size, shape, or look. Assessing the level of copper in the blood is not a standard test for MDS. But, it may be done in certain cases to rule out other causes of the abnormal appearance or number of blood cells. HIV testing HIV can cause low blood cell counts. It can also cause blood cells to have an abnormal size, shape, or look. In certain cases, tests may be done to rule out HIV as the cause of these symptoms. HLA typing HLAs are special proteins found on the surface of most cells in the body. The unique set of HLA proteins on a person’s cells is called the HLA type or tissue type. All cells in a single person have the same HLA type. This helps the body to tell its own cells apart from foreign cells. It also affects how the body responds to foreign substances. HLA typing is a blood test that finds a person’s HLA type. This test is not needed for all patients with MDS. It is only used in certain cases, such as to find the right donor for treatment with a platelet transfusion or hematopoietic cell transplant. This is because your tissue type and the donor’s tissue type must be a near-perfect match for this treatment to work. Flow cytometry Flow cytometry looks at the proteins on the surface of cells in a sample of blood or bone marrow. In some cases of MDS, this test may be used to identify the specific type of cells present.