Lower-Risk MDS

Management - anemia

luspatercept

• TGF-b superfamily, promotes late-stage erythropoeisis
• MDS-RS (usu SF3B1-mutant)
• tfx independence in ~40% (~10% in placebo)¹
• median duration of response ~30wks
• diarrhea, nausea, back pain, dizziness in 20%

lenalidomide

• del(5q) (sometimes non-del(5q) if used in combo w epoeitin alfa)
• 21/28d cycles
• 2011 RCT: tfx independence in 40-60%
• median duration of response >2y
• G3-4 neutropenia 70%, thrombocytopenia in ~33%