Management of luspatercept therapy in patients with transfusion-dependent β-thalassaemia

Br J Haematol. 2023 Jun;201(5):824-831. doi: 10.1111/bjh.18801. Epub 2023 Apr 10.

Abstract

Patients with transfusion-dependent β-thalassaemia require lifelong, regular red blood cell transfusions for survival; however, frequent blood transfusions are associated with an increased risk of iron overload, transfusion-transmitted disease and alloimmunization, as well as reduced quality of life. Luspatercept, an erythroid maturation agent that promotes late-stage erythroid maturation independently of erythropoietin, has demonstrated efficacy in reducing transfusion burden in patients with transfusion-dependent β-thalassaemia. In this review, we discuss treatment initiation, ongoing evaluation, dose adjustment and management of adverse events in transfusion-dependent patients with β-thalassaemia receiving luspatercept, and we provide guidance on how to determine whether patients are deriving clinical benefit.

Keywords: adverse event management; dose management; haemoglobin; luspatercept; β-thalassaemia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Humans
  • Immunoglobulin Fc Fragments* / therapeutic use
  • Immunologic Factors* / therapeutic use
  • Iron Overload / chemically induced
  • Iron Overload / etiology
  • Quality of Life
  • beta-Thalassemia* / complications
  • beta-Thalassemia* / drug therapy

Substances

  • Immunoglobulin Fc Fragments
  • luspatercept
  • Immunologic Factors