Critères d'inclusion : - Age ≥ 18 years
- MDS according to WHO 2016 criteria, with low or int 1 classical IPSS
- Non-RBC transfusion dependent anemia
- Hb level between 9 and 10.5g/dl (at the center's lab)
- Hb level should be at least 1g/dl higher than the Hb threshold chosen to start RBC transfusions based on age, comorbidities and predicted clinical tolerance of anemia (this transfusion threshold should be chosen between 8 and 9g/dl)
- Serum EPO level <500U/l
- No other cause of anemia (including iron deficiency, vitamin B12 or B9 deficiency, hemolysis, hypothyroidism….)
- Performance status <=2
Critères de non-inclusion : - Higher risk MDS (IPSS intermediate-2 or high)
- Del 5q
- Baseline Hemoglobin level > 10.5 g/dl or <9g/dl
- Transfusion threshold (based on age , comorbidities…) >9g/dl
- Transfusion threshold less than 1 g/dl below baseline Hb level
- RBC transfusion dependence. Patients may have received only one transfusion series for MDS prior to inclusion
- CMML , if >10 % BM blasts or WBC>13.000/mm3
- Uncontrolled hypertension
- Uncontrolled cardiovascular disease including angina pectoris or cardiac failure
- Renal failure: Creatinine clearance<40ml/min (using MDRD formula)
- Pregnancy (positive bettaHCG) or nursing