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A 70-Year-Old Man with Anemia in ESA Naive Lower-Risk Myelodysplastic Syndrome (LR-MDS)

A panelist discusses a typical lower-risk myelodysplastic syndrome case managed with luspatercept over erythropoiesis-stimulating agents due to its convenient every-3-week dosing and favorable early response, emphasizing how treatment decisions should align with patient lifestyle, anemia severity, and goals of improving hemoglobin levels, minimizing transfusions, and enhancing quality of life.

A panelist highlights that updated COMMANDS trial data demonstrate luspatercept’s robust efficacy in erythropoiesis-stimulating agent–naive patients with low-risk myelodysplastic syndrome—achieving high rates of durable transfusion independence and hemoglobin improvement across subgroups—with emerging evidence suggesting potential long-term survival benefits and a favorable safety profile.

A panelist emphasizes that recent real-world retrospective data from 103 first-line luspatercept-treated patients closely align with, and even slightly exceed, COMMANDS trial results—demonstrating significant hemoglobin improvements and transfusion independence—thereby reinforcing luspatercept’s effectiveness and practical value in routine clinical care for erythropoiesis-stimulating agent–naïve, low-risk patients with myelodysplastic syndrome.

A panelist notes that while new treatments like luspatercept and imetelstat offer hope beyond traditional erythropoiesis-stimulating agents—which fail in many patients and provide limited response duration—variability in patient response, influenced by factors such as mutation burden, underscores the need for personalized therapies and continued development of agents that can modify disease progression and improve survival in low-risk myelodysplastic syndrome.