Impact of Mutational Landscape and Burden on RBC Transfusion Response in Patients With Lower-Risk Myelodysplastic Syndromes (LR-MDS) in the COMMANDS Study.

ABSTRACT: The COMMANDS trial established luspatercept as a first-line treatment for anemia in transfusion-dependent lower-risk (LR) myelodysplastic syndromes (MDS). Here we report red blood cell (RBC) transfusion response analysis based on somatic mutations profile and disease risk for patients treated with luspatercept or epoetin alfa in the COMMANDS trial. Of 350 evaluable patients, 238 (68.0%) had MDS with multiple lineage dysplasia and ring sideroblasts (RS) according to World Health Organization 2016 criteria, and 320 (91.4%) had somatic mutations in ≥ 1 gene (median, 2) with median variant allele frequencies (VAF) of 2%-59%. Mutation profiles were similar in the treatment groups. Luspatercept had superior responses versus epoetin alfa across multiple mutations (risk difference; RD, [95% confid

SUBMITTER: Komrokji RS 

PROVIDER: S-EPMC12868996 | biostudies-literature | 2026 Mar

REPOSITORIES: biostudies-literature