The goal of this registry is to study the impact of iron overload and chelation on survival and
organ function in MDS. A significant percentage of patients with lower risk MDS require
ongoing blood transfusions for prolonged periods in spite of improvements in current MDS
therapies. Evaluations of the long-term impact on morbidity and mortality in a prospective
cohort of MDS patients have not been published. This trial will evaluate the impact of
chelation therapy on morbidity and mortality in lower risk MDS patients.

The study is composed of a 26-week placebo controlled test treatment period (romiplostim versus Placebo), a 2 to 4 week interim wash-out period, a 24-week placebo controlled extended treatment period, and a 4-week follow-up period. During the interim wash-out period, a bone marrow biopsy will be performed in the absence of growth factor to assess changes in the marrow. In the extended treatment period, safety assessments will continue and subjects will be allowed to receive any standard of care treatments for MDS. Subjects will be followed for survival for an additional 60 months following the End of Study (EOS) visit.