A roundtable discussion on anemia management in myelodysplastic syndromes, featuring moderator Guillermo Garcia-Manero, MD, of the University of Texas MD Anderson Cancer Center; Amy DeZern, MD, MHS, Johns Hopkins Medicine; Tiffany Tanaka, MD, of the University of California San Diego; and Uma Borate, MBBS, of Ohio State University.
The following is a transcript:
Maybe, Uma can walk us through this. So how do you approach patients with anemia today?
I think like Amy said, this is just a great time because I think we have so many more options than we did when I was a fellow, for example. And I think, if you obviously have calculated your risk score, you know, your patient has low risk MDS, they have anemia. I’m very much a proponent of listening to the patient.
And I think for me, it’s not as much what their hemoglobin is, it’s the combination of what their hemoglobin is but what how they’re feeling. And I think you see a whole spectrum depending on what the patient’s baseline functionality is. As to, you know, how symptomatic there are, some patients have no symptoms and feel perfectly fine, and others really notice that they have a lot of fatigue and they’re very compromised in their ability to do things.
We were talking earlier about pickleball is suddenly very popular in the US, and for them they notice that they can’t actually play a game. And that’s important to them. So I think that’s a big part of the conversation I have with my patients. And I think the other part is, well, what are the drugs available to us?
So obviously we all know ESAs are frontline in this indication. We know the story of luspatercept, which was something that was became available to us as a second line option. After ESA failures, we recognize that their effectiveness of 3B1 ring sideroblast. And then you have the command study, which we’ll talk about. So I think the the the fact that we have all these options available is great.
But I agree with Tiffany. It’s the sequencing. How do you select the frontline option knowing that there’s possibilities that they will lose response at some point in time.
