Luspatercept in low-risk myelodysplastic syndromes: a paradigm shift in treatment strategies

Introduction In patients with myelodysplastic syndromes (MDS), anemia is prevalent affecting 80%–85% of low-risk (LR-MDS) patients, with 40% eventually requiring red blood cell (RBC) transfusions. Except forlenalidomide, exclusively approved for those with deletion of chromosome 5q,erythropoiesis-stimulating agents (ESAs) are the primary treatment choice for low-risk patients. Those unresponsive to ESAs face limited alternatives, eventually necessitating long-term RBC transfusions, leading to secondary iron overload and adversely affecting quality of life (QoL).