Abstract: Myelodysplastic syndrome (MDS) is a group of highly heterogeneous diseases. Anemia is the most common manifestation of MDS, which is also an important factor affecting the survival and quality of life in MDS patients. Different factors are involved in the pathogenesis of anemia of MDS, and for a particular patient, anemia maybe the results of multiple factors. In current review, we summarized the common reasons for MDS anemia including expansion of abnormal clone, immune regulation dysfunction, abnormal hematopoiesis concerning with 5q-, ineffective hematopoiesis and iron overload. Erythropoietin (EPO), immunosuppressive agent, iron chelators, immunomodulatory, transforming growth factor beta (TGF- β) pathway inhibitor, demethylation drugs and hematopoiesis stem cell transplantation may help to improve the anemia of different causes in MDS patients.

Key words: myelodysplastic syndromes, anemia, cause of disease, origin of a disease