Reducing Red Blood Cell Transfusions in Lower-Risk Myelodysplastic Syndromes

Adults with lower-risk myelodysplastic syndromes (MDSs) often become red cell (RBC) transfusion-dependent, with only a minority having durable responses to erythropoiesis-stimulating agents (ESAs). Investigators now report the final analysis of the industry-sponsored, multinational, open-label, phase 3 COMMANDS trial comparing luspatercept to epoetin alfa in transfusion-dependent patients with very low, low, or intermediate risk MDS (as defined by the Revised International Prognostic Scoring System). Patients who had not received prior ESA treatment were randomized to subcutaneous luspatercept (1 mg/kg titrated up to 1.75 mg/kg, once every 3 weeks) or subcutaneous epoetin alfa (450 IU/kg titrated up to 1050 IU/kg once per week) for at least…