Myelodysplastic Syndromes at ASCO 2024

CME

Individualizing Therapy in Low-Risk MDS: New Evidence and Options for Your Patients

Physicians: Maximum of 1.00 AMA PRA Category 1 Credit

Released: June 14, 2024

Expiration: December 13, 2024

Rami Komrokji
Rami Komrokji, MD
Maximilian Stahl
Maximilian Stahl, MD

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

Patient Case



  • A 64-yr-old woman with increasing fatigue over the past 9 mo

  • She has isolated normocytic anemia with hemoglobin 8.6 g/dL  

  • A complete anemia workup revealed mild erythroblastic dysplasia with ring sideroblasts and an SF3B1 mutation, no del(5q)

  • She is found to have an IPSS-R score of 2 and EPO level of 390 U/mL

  • RBC transfusion dependent: 3 RBC units/8 wk

In your clinical practice, how would you manage this patient’s anemia? 

2.

Patient Case Follow-up



  • Your patient was treated with luspatercept 1 mg/kg Q3W

  • After 6 wk, her Hb is 8.8 and she is still symptomatic

  • During this time, she has received 1 additional transfusion

In your clinical practice, which of the following would be the next best step for this patient? 

3.

Patient Case



  • A 70 yr-old man presents with anemia

  • A complete workup reveals low-risk MDS (IPSS: 0.5; IPSS-R: 2) with mutated DNMT3A and SF3B1, non del(5q)

  • Anemia managed with an ESA for >18 mo

  • Your patient complains of fatigue and has worsening anemia 2 yr later

    • Hb 7 g/dL, WBC 6.1, platelets 270,000/mm3

    • MDS-RS-MLD with no increase in the bone marrow blasts

    • Ring sideroblasts: 55%

    • Cytogenetics are still normal



Assuming all agents were approved, which of the following would be optimal for managing this patient’s anemia? 

4.

How confident are you in identifying patients with lower-risk MDS who are eligible for ongoing clinical trials?