Musallam Khaled M, Taher Ali T
Center for Research on Rare Blood Disorders, Burjeel Medical City, Abu Dhabi, United Arab Emirates.
Division of Hematology/Oncology, Department of Pediatrics, Weill Cornell Medicine, New York, NY.
Hematology Am Soc Hematol Educ Program. 2024 Dec 6;2024(1):419-425. doi: 10.1182/hematology.2024000567.
Patients with β-thalassemia continue to have several unmet needs. In non-transfusion-dependent patients, untreated ineffective erythropoiesis and anemia have been associated with a variety of clinical sequelae, with no treatment currently available beyond supportive transfusions. In transfusion-dependent forms, lifelong transfusion and iron chelation therapy are associated with considerable clinical, psychological, and economic burden on the patient and health care system. Luspatercept is a novel disease-modifying agent targeting ineffective erythropoiesis that became recently available for patients with β-thalassemia. Data from randomized clinical trials confirmed its efficacy and safety in reducing transfusion burden in transfusion-dependent patients and increasing total hemoglobin level in non-transfusion-dependent patients. Secondary clinical benefits in patient-reported outcomes and iron overload were also observed on long-term therapy, and further data from real-world evidence studies are awaited.
β地中海贫血患者仍有一些未满足的需求。在非输血依赖型患者中,未经治疗的无效红细胞生成和贫血与多种临床后遗症相关,目前除了支持性输血外没有其他可用的治疗方法。在输血依赖型患者中,终身输血和铁螯合疗法给患者和医疗保健系统带来了相当大的临床、心理和经济负担。罗特西普是一种针对无效红细胞生成的新型疾病修饰药物,最近可供β地中海贫血患者使用。随机临床试验的数据证实了其在减轻输血依赖型患者输血负担和提高非输血依赖型患者总血红蛋白水平方面的疗效和安全性。长期治疗还观察到患者报告结局和铁过载方面的次要临床益处,目前正在等待来自真实世界证据研究的进一步数据。