The Effects of Luspatercept on Hemoglobin Levels

In patients with lower-risk MDS, first-line treatment with luspatercept demonstrates faster and more robust improvements in hemoglobin compared with first-line ESA therapy. Early initiation of luspatercept is associated with a higher likelihood of achieving meaningful hemoglobin responses, particularly in patients whose baseline hemoglobin is above a critical threshold. In contrast, those already dependent on red blood cell transfusions at baseline are less likely to reach optimal hemoglobin levels. These findings highlight the clinical value of addressing anemia early in the disease course, before significant hemoglobin decline or transfusion dependence develops.