
Panelists discuss how to approach case-based treatment decisions in patients with lower-risk MDS, examining a 77-year-old man with symptomatic anemia (hemoglobin, 7.6 g/dL; EPO, > 200 mU/mL; SF3B1-negative) who would benefit from luspatercept but faces insurance barriers without transfusion dependence, and a 70-year-old woman for whom erythropoiesis-stimulating agent (ESA) therapy was not successful and who requires second-line treatment. The experts debate personalized approaches considering molecular features, patient goals, and the balance between luspatercept and imetelstat based on individual clinical characteristics.

















