BACKGROUND: Limited evidence exists from routine clinical practices on patient characteristics and treatment patterns in patients treated with luspatercept for lower-risk myelodysplastic syndrome (LRMDS).
AIMS: This study aimed to describe baseline demographic and clinical characteristics and patterns of therapy in patients with LR-MDS receiving treatment with luspatercept in Canada, Germany, and Spain.
METHODS: This was a noninterventional, retrospective medical records review study. Patients aged ≥18 years, diagnosed with LR-MDS, and treated with luspatercept after its approval in respective countries were identified for study inclusion by participating hematologists/hem-oncologists (data abstraction period: Oct–Nov 2023). Abstracted data on baseline patient characteristics (e.g., demographics, comorbidities, genetic risk factors) and luspatercept treatment patterns (e.g., line of therapy, dosage, time to treatment discontinuation) were analyzed descriptively. Findings reported here are based on interim data collected through November 2023 for Canada, Germany, and Spain.
RESULTS: Data were abstracted by 47 participating physicians for a total of 114 eligible patients (56 Germany, 52 Spain, and 6 Canada). Median age was 71 years (range: 40-92), 59.6% were male, and 92.1% were white. Revised International Prognostic Scoring System (IPSS-R) risk status was very low or low for nearly two-thirds (64.9% [among 111 patients with recorded data]) at LR-MDS diagnosis and for approximately half (53.8% [among 65 patients with recorded data]) at luspatercept initiation. Luspatercept use was most common in the second line (2L, 57.9%), followed by first line (1L, 33.3%) and third line or later (3L+, 8.8%). Among previously treated patients (n=76), almost all received erythropoietin-stimulating agent (94.7%) before initiating luspatercept. Median follow-up duration was 21.5 months from LRMDS diagnosis. Median time from LR-MDS diagnosis to luspatercept initiation was 10.7 months (median time to initiation in 1L was 0.9 months). Median dose at luspatercept initiation was 1 mg/kg per administration among those with known dosing data (n=103), with a majority (91.3%) receiving a 3-weekly cycle. Approximately 17.5% (n=20) received a dose increase; the median dose as of the last follow-up, reported for 17 patients with a dose increase, was 1.3 mg/kg per administration, cycled every 3 weeks. Median follow-up duration from luspatercept initiation was 8.9 months, and median duration of therapy over this period EHA2024 | Abstract Submission was 8.7 months. Overall, 14.9% (n=17) discontinued therapy, and of those with known dosing information (n=15), 40% had a dose escalation before discontinuation.
SUMMARY/CONCLUSION: This study provides early insights into the prevailing patterns of luspatercept utilization in routine clinical practice in Canada, Germany, and Spain and is expected to inform ongoing and future evaluations of this treatment option for patients with LR-MDS.
