Approach to 1L Therapy Selection in LR-MDS

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EP: 1.Approach to 1L Therapy Selection in LR-MDS

EP: 2.IPSS-M: A Clinical-Molecular Prognostic Model for LR-MDS

EP: 3.Impact of Molecular Prognostic Models on LR-MDS Management

EP: 4.COMMANDS Trial: Efficacy and Safety Findings

EP: 5.Assessing Quality of Life in MDS Patients

EP: 6.Transitioning from ESAs to EMAs in MDS Treatment

EP: 7.Clinical Benefits of Luspatercept Dose Titration: Real-World Evidence

EP: 8.Optimizing Anemia Management in LR-MDS: Key Takeaways and Unmet Needs

Case: SF3B1+ MDS-RS: IPSS-M-Guided 1L Luspatercept

Clinical Presentation:

70-year-old man diagnosed 6 months ago with LR-MDS with multilineage dysplasia - moderate anemia (Hb 11.2) and thrombocytosis (PLT 500,000 μl)

• SF3B1 mutation positive
• Non-del(5q)
• No family history of cancer or significant genotoxic agent exposure
• IPSS-R: Low
• IPSS-M: SF3B1α mutation [SF3B1, ASXL1 and TET2 mutations]

Current Visit Clinical Workup and Diagnosis:

• Serum EPO - 250m U/L, Ring sideroblast (RS) agnostic (either positive or negative)
• Hgb: 8.2 g/dL.
• WBC and ANC: WNL
• PLT: 450,000 μl

He complains of increasing fatigue over the past 1-2 months. He normally plays 2-3 rounds of golf a week. Lately he has only been playing a full round once a week and maybe 9 holes on another day.

Initial Treatment(s):

• The patient was started on luspatercept at the starting dose [1.0 mg/kg] as 1L therapy.
• After 24 weeks, the patient has not received any transfusion and his Hgb is now 10.7 g/dL.