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

Patients with transfusion-dependent beta-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 beta-thalassaemia. In this review, we discuss treatment initiation, ongoing evaluation, dose adjustment and management of adverse events in transfusion-dependent patients with beta-thalassaemia receiving luspatercept, and we provide guidance on how to determine whether patients are deriving clinical benefit.