ASCO 2024 | Does imetelstat increase the need for platelet transfusions & growth factors in pts with LR-MDS?

We also presented an update from the IMerge study, which was the phase three that evaluated imetelstat as a second line option for the management of anemic, transfusion dependent patients with lower risk MDS as a second line treatment. And it was already known that the transfusion dependence raised was around 38% with imetelstat as compared to placebo, which was around 15%. In this particular analysis, we looked at the issue of the cytopenias, and there was always this question about having thrombocytopenia and neutropenia as a side effect of imetelstat, but we wanted to look at the functional consequences of thrombocytopenia and neutropenia in the sense of how often are patients needing platelet transfusions, which indicates very severe thrombocytopenia, and how often patients need growth factor support in the form of G-CSF. And of course, we already knew that neutropenia was not leading to a higher rate of severe infections, leading to hospitalizations, for example, or infectious deaths with imetelstat compared to placebo and the same thing with there was no increased incidence of severe bleeding with imetelstat as compared to placebo. In this particular analysis, we looked at the median number of platelet transfusion needed, and it was only one unit as a median for patients who received imetelstat. And there was a median only of four doses of growth factor G-CSF given for neutropenia. So while thrombocytopenia and neutropenia certainly is more common with imetelstat, the functional consequences of those were not increased in terms of severe complications and transfusion need support. And that, in my mind, confirms that those cytopenias are manageable and we should be able to dose this drug in the community setting with careful monitoring of blood counts. So of course, all of us are waiting at this point for the approval of the drug, which we hope to happen by within the next couple of weeks actually.