The myelodysplastic syndromes are a heterogeneous group of clonal disorders of hematopoietic stem cells characterized by dysplasia and ineffective blood cell production. The erythropoiesis stimulating agents (ESA) represent an alternative therapy for a group of patients with myelodysplastic syndromes. A systematic literature review of randomized controlled trials that evaluated the efficacy and safety of ESAs in adults diagnosed with myelodysplastic syndrome until February 2014. From the search is found 1071 references, 12 references were obtained corresponding 9 studies that met the selection criteria. All ESA assessed a comparator group but differed between them; Of the selected studies, none assessed the outcome of survival by treatment arm. 3 of the studies evaluated the outcome of quality of life in different comparison groups reported no statistically significant improvements. 7 studies evaluated reporting hematologic response divergent results according to various definitions of the variable of interest. Safety outcomes were reported in 3 studies, occurring in low proportion and with similar rates in comparator groups and treatment with ESA. Risk assessments of bias considered a study with low risk of bias, 4 studies with uncertain risks, and 4 studies with high risk of bias. The studies evaluated were considered most at risk of uncertain or high bias. It is suggested to evaluate these outcomes interest in a standardized manner in future research on the subject.
