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FDA approval was extended to erythropoiesis stimulating agent-naive patients with very low- to intermediate-risk MDS, irrespective of ring sideroblast status, after the COMMANDS trial 41 showed that luspatercept induced higher rates of red blood cell (RBC) transfusion independence for at least 12 weeks with concurrent mean Hb increase of 1.5 g/dL (weeks 1-24) than did epoetin alfa (59% vs 38%)

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