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Treatment Name: Luspatercept (Reblozyl®)

Luspatercept (Reblozyl®) is a Treatment Regimen for Myelodysplastic Syndromes (MDS)

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References

1) Fenaux P, Platzbecker U, Mufti GJ, et al. Luspatercept in Patients With Lower-Risk Myelodysplastic Syndromes. N Engl J Med 2020;382(2):140-151

Created: September 3, 2020 Updated: September 3, 2020

What is Myelodysplastic Syndromes (MDS)?

Myelodysplastic Syndromes (MDS) are a group of blood disorders where the bone marrow either fails to make mature blood cells, or immature cells build up and crowd out normal cells preventing them from developing normally.

This often results in the bone marrow producing too few blood cells leading to: 1) A low white blood cell count (neutropenia), which can increase the risk of infection; 2) A low red blood cell count (anemia), which may contribute to weakness, fatigue, or shortness of breath; or 3) A low platelet count (thrombocytopenia), which can increase the risk of bleeding. Depending upon the type of MDS, some patients have neutropenia, AND anemia, AND thrombocytopenia.

In newly diagnosed cases of MDS, the causes are not always known. This is sometimes referred to as “de novo” MDS. However, exposure to certain chemicals, radiation, and chemotherapy are known to increase the risk of MDS. When causes are known, this is referred to as "secondary MDS." There are various subtypes of MDS and treatment depends on the specific subtype and risk level. High risk patients may be treated more aggressively than low risk patients. The effectiveness of treatment often depends upon the type of MDS as not all types respond the same way to treatment.

NOTE: Treatment Options listed below are not all-inclusive. Other treatments may be available. ChemoExperts provides drug information and does not recommend any one treatment over another. Only your Doctor can choose which therapy is appropriate for you.

What does Cure mean?

The word “cure” means there are no cancer cells left in the body and cancer will never come back. Depending on the cancer type and stage, this may be the true goal of therapy. However, it is very difficult to prove all cancer cells are gone. Even though images, like X-rays and MRI’s, and blood tests may not show any signs of cancer, there can be a small amount of cancer cells still left in the body. Because of this, the word “remission” is used more often. This means there are no signs or symptoms of cancer. Patients in remission are followed closely for any signs of cancer returning. Sometimes, more chemotherapy may be given while in remission to prevent the cancer from coming back.

Doctors usually do not consider a patient “cured” until the chance of cancer returning is extremely low. If cancer does return, it usually happens within 5 years of having a remission. Because of this, doctors do not consider a patient cured unless the cancer has not come back within 5 years of remission. The five-year cutoff does not apply to all cancers.

Common Starting Doses

  • Typical starting dose: 1 mg/kg subcutaneous (SubQ) injection once every 3 weeks
    • If your need for blood transfusions doesn’t decrease after 6 weeks, your dose of luspatercept may increase
    • If your hemoglobin increases too rapidly inbetween treatments, your dose of luspatercept may need to be decreased

Note: Individual doses may vary based upon your Doctor's recommendation, or drug availability.

What is a CBC?

A Complete Blood Count (CBC) is a frequently ordered blood test that tells clinicians the status of your: 1) White blood cell count, 2) Hemoglobin, and 3) Platelet count at the time the test was taken.

Common uses:
1) White blood cell count (WBC): is used to determine infection risk, or response to chemotherapy. Certain chemotherapy agents may harm our good infection-fighting cells. Sometimes chemotherapy may need to be delayed to allow these cells to recover.

2) Hemoglobin: is used to determine if someone is anemic. Anytime the hemoglobin is below 12 g/dL, the person is said to be anemic. Red blood cell transfusions, and sometimes iron can be given to restore the hemoglobin level, but anemia treatment should always aim at treating the underlying cause or condition.

3) Platelet count: is used to determine if the risk of bleeding is increased or if a platelet transfusion is required to prevent bleeding. Certain medications that increase bleeding risk, such as: aspirin, certain chemotherapy agents, and blood thinners, may need to be stopped temporarily until the platelet count is within a safe range.