Dealing With Transfusion Dependence in Patients With MDS

Abdulraheem Yacoub, MD, professor of Hematologic Malignancies and Cellular Therapeutics at the University of Kansas Medical Center, discusses option for patients with myelodysplastic syndromes (MDS) and red blood cell transfusion dependence.

For patients with MDS, transfusion dependence is a significant burden characterized by progressive anemia, according to Yacoub. Management can involve addressing reversible risk factors like nutritional deficiencies and giving medications affecting hemoglobin.

Established treatments include erythropoietin-stimulating agents (ESAs) and danazol (Danocrine). There have also been recent FDA approvals of novel agents, such as luspatercept (Reblozyl) and imetelstat (Rytelo). Yacoub says these therapies have revolutionized treatment options, offering new hope for patients with MDS. These advancements complement existing therapies like transfusion support, lenalidomide (Revlimid), and danazol.

TRANSCRIPTION:

0:10 | Transfusion dependence is a big burden to patients with MDS. A hallmark of MDS is anemia that is universally progressive. Some patients progress with their MDS with anemia only and heavy transfusions, and usually that is a long-term challenge that they have to come across, which utilizes a lot of their time and healthcare resources. It's an unmet need, and we do not have as many tools as we would like to, but those tools are getting bigger and more diverse.

0:44 | As a general practice, we always look for reversible risk factors: nutritional deficiencies, renal dysfunction, any medications that can suppress the hemoglobin or cause hemolysis…anything that we could reverse or fix. And then for other patients, in addition to transfusion support, we utilize the tools that we historically had, including ESAs, danazol, or other agents that we have used over the years to try to support patients.

1:27 | Fortunately, we have had recent FDA approvals of 2 novel agents that we are utilizing, including the luspatercept and imetelstat. This has recently revolutionized the way we address these patients, in addition to the older options we've used, which are [lenalidomide] and danazol and transfusion support and ESAs.