Latest news with #transfusion
Medscape
3 days ago
- Health
- Medscape
Luspatercept May Prolong Life in Low-Risk MDS
A new analysis from the COMMANDS trial of erythroid maturation agent luspatercept in patients with lower-risk myelodysplastic syndromes (MDS) shows not only sustained, longer-term benefits over epoetin alfa in providing significantly greater independence from transfusions but also, importantly, a promising trend in reducing disease progression and even improving survival. 'We're starting to see a very significant trend in terms of lower rate of transformation and an improvement in survival for patients treated with luspatercept vs epoetin alfa, and I believe this is the first example of this phenomenon ever reported in low risk MDS,' said first author Guillermo Garcia-Manero, MD, of the University of Texas MD Anderson Cancer Center, in Houston, in presenting the findings at American Society of Clinical Oncology (ASCO) 2025 in Chicago. In previously reported primary results, the phase 3, global COMMANDS trial showed luspatercept to be the first therapy to have superiority over erythropoiesis-stimulating agents (ESAs) in transfusion-dependent lower-risk MDS. The findings were especially important, as ESAs had for decades represented the first-line treatment for patients with lower-risk MDS. They were described as leading the way to a 'paradigm shift,' with luspatercept subsequently approved in the first-line and second-line treatment of patients with anemia and low-risk MDS. For the new analysis, Garcia-Manero and colleagues reported the first results regarding longer-term duration of responses, safety, and survival of patients treated for more than 2.5 years. In the study, patients in the luspatercept group (n = 182) received 1.0-1.75 mg/kg subcutaneously every 3 weeks, while those in the epoetin alfa arm (n = 181) received 50-1050 IU/kg, with a maximum dose of 80,000 IU, subcutaneously every week, for at least 24 weeks in both groups. In the new analysis, with a median follow-up of 30.6 months in the luspatercept arm and 28.8 months in the epoetin alfa arm, patients treated with luspatercept vs epoetin alfa had a slower rate of disease progression, with just 2.2% vs 5.6% progressing to higher-risk MDS (hazard ratio [HR], 0.388). While the difference was not significant ( P = .1003), 'what we see is a phenomenon that is emerging that is quite significant in that there is indeed a slower rate of progression in the luspatercept arm vs the epoetin alfa,' Garcia-Manero explained. Of note, however, there was no significant difference between the groups in terms of progression to acute myeloid leukemia (4.9% vs 4.4%). Long-Term Treatment Response In terms of long-term treatment response outcomes, red blood cell transfusion independence of at least 12 weeks was achieved by 76.4% (139/182) of patients on luspatercept vs 55.8% (101/181) of those on epoetin alfa (odds ratio [OR], 2.8; P < .0001). The median cumulative duration of transfusion independence through the end of treatment was 150.0 weeks for luspatercept and 95.1 weeks for epoetin alfa (HR, 0.52; P = .0011). 'The results basically show that patients receiving luspatercept are responding for almost a year longer vs the epoetin alfa,' Garcia-Manero noted. Overall Survival Median overall survival in the intention-to-treat population for luspatercept was not reached, while the rate was 46.7 months for epoetin alfa (HR, 0.86). A regression analysis showed six deaths among 68 patients (8.8%) in the luspatercept arm vs 15 deaths among 55 patients (27.3%) in the epoetin alfa arm (HR, 0.330; P = .02). Importantly, the survival curves begin to separate at 36 months — while the 3-year overall survival rates were 63.8% with luspatercept and 62.2% with epoetin alfa, by 5 years, the overall survival rates were 54.0% and 41.8%, respectively, in favor of luspatercept. 'This is very encouraging data suggesting that those patients treated on the luspatercept arm appear to have a longer longevity that those patients in the epoetin alfa arm,' Garcia-Manero said. Furthermore, subgroup analysis of overall survival based on patient characteristics, including transfusion burden, ring sideroblast activity, and baseline serum erythropoietin (EPO) levels, showed survival favoring luspatercept in all groups. 'I think the data this [subanalysis] data is quite important because there have been some questions in terms of what should be the first-line agent to use in a patient with lower risk disease with a [higher] EPO level,' Garcia-Manero said. 'So if we're looking now looking at an intervention that may be changing the natural history of the disease, I think this is quite significant,' he said. Mechanisms? In terms of the mechanisms that might underlie improvements in survival, Garcia-Manero noted that 'there is emerging data that, for instance, [luspatercept] may modulate not only TGF [transforming growth factor] beta but some other innate immunity pathways that are very important for the behavior of the stem cell in MDS,' he explained. 'Furthermore, the [improved overall survival] may not be just mediated by the need for fewer transfusions or higher hemoglobin levels, but there may be actually some biology behind how these drugs work that could be changing natural history of patients with low-risk MDS,' Garcia-Manero said. Findings Are 'Surprising' Commenting on the study, Pamela Sung, MD, PhD, an assistant professor in the Departments of Medicine and Pharmacology & Therapeutics, Roswell Park Comprehensive Cancer Center, Buffalo, New York, who co-moderated the ASCO session, underscored that the results were not anticipated. 'These findings are a surprise, as there has not been a previous study in low-risk MDS that has shown a potential survival benefit,' Sung said in an interview. 'The reason for this improvement is still under investigation as there were no differences between the groups for transformation to AML' — which may have logically explained differences in survival. Of note, 'there was a clear split of the survival curves beginning at 3 years, which is encouraging that these results will hold with longer follow-up,' she added. The findings underscore that 'luspatercept has sustained responses in terms of RBC transfusion independence,' Sung said. 'Preliminary evidence suggests potential disease-modifying activity and survival benefit in low-risk MDS.' Speaking from the audience, Steven Vogl, MD, an oncologist based in the Bronx, New York, speculated on the potential role of subsequent therapies used after failing on epoetin alfa as increasing deaths in that group. 'If patients fail erythropoietin, they may get more transfusions, and/or more treatment or therapies that can cause, for instance, iron overload,' he noted. 'And [that therapy], which was delayed in the luspatercept group, could have had toxicity and made patients weaker, potentially leading to [higher rates of] death in the epoetin alfa group.' He added that while the cause of death can sometimes be hard to pin down in such studies, 'toxicity isn't so hard.' Garcia-Manero responded, 'I totally agree. The mission for us is to start understanding this a little bit better,' he said. 'I don't think it is as simple as [the luspatercept group] just having fewer transfusions, but I may be wrong. The analysis is ongoing.' The study was sponsored by Celgene and Acceleron Pharma.
CNET
30-05-2025
- General
- CNET
I Had No Clue About My Blood Type -- Here's How I Finally Found Out
I never really thought much about my blood type until I needed to know it. A couple of years ago, I was filling out a volunteer application for a children's hospital, and one of the questions asked for my blood type. I knew I was O-positive, but I wanted to double-check just to be sure. First, I called my mom to see if it was listed on my birth certificate. It wasn't. Then I checked my doctor's online health portal -- nothing there either. That's when I realized a lot of people probably don't know their blood type, and that could be a big problem in an emergency. Your blood type matters more than you might think. It can affect everything from your risk for certain conditions to how your body handles a blood transfusion. If you're not sure what yours is, there are a few easy ways to find out, and trust me, it's worth knowing. This got me wondering: How does someone discover their blood type if they don't already know it? The good news is that finding out your blood type is relatively simple, and you have options. Below are three easy ways to find out your blood type. Blood type basics CNET Blood type is categorized into one of these eight groups: A-positive, A-negative, B-positive, B-negative, O-positive, O-negative, AB-positive and AB-negative. But what determines blood type and what does that blood type mean? Blood types are determined by antigens -- a substance that triggers an immune response -- on the surface of red blood cells. There are ABO antigens, which designate ABO blood types. This is determined by the ABO gene. For example: Type A blood type has the A antigen blood type has the A antigen Type B blood type has the B antigen blood type has the B antigen Type AB blood type has both the A and B antigen blood type has both the A and B antigen Type O doesn't produce any A or B antigen There are also Rhesus (Rh) antigens, which determine if blood is "positive" or "negative." If you have Rh proteins on the surface of your red blood cells, you are Rh positive. If you don't have Rh proteins on the surface of your red blood cells, you have negative blood. Blood type is categorized into one of these eight groups: A-positive, A-negative, B-positive, B-negative, O-positive, O-negative, AB-positive and AB-negative. Ekachai Lohacamonchai/EyeEm/Getty Images How to find your blood type? Here's three main ways to type your blood: Have your doctor do a blood test Donate blood Use an at-home blood test 1. Clinical test One of the easiest and most effective ways to determine your blood type is to have your doctor perform a test. A professional will draw blood and then perform two tests on the blood sample: forward typing and reverse typing. During forward typing, the blood sample is mixed with antibodies against type A and B blood. Based on whether the blood cells stick together when mixed with the antibodies, your blood type can be determined from there. If your blood cells stick together when mixed with antibodies against type B blood, you have type B blood. If your blood cells stick together when mixed with antibodies against type A blood, you have type A blood. To confirm the result, the next step is reverse typing, meaning the blood sample without red blood cells -- called a serum -- is mixed with type A and type B blood cells. Type A blood will have antibodies against Type B blood in the sample and type B blood will have antibodies against Type A blood. Type O blood will contain antibodies against Type A and Type B. So, if sticking occurs when the serum is mixed with type B blood cells, you have type A blood, and if sticking occurs when the serum is mixed with type A blood cells, you have type B blood. I recommend calling your doctor's office to see what a blood type test costs out-of-pocket and if it's covered by insurance. 2. Donate blood This is an easy -- and free -- way to determine blood type, but results are not immediate. If you donate to a blood drive, you can simply ask the staff about your blood type. Blood usually is not tested right away, so it may take up to a few weeks to get the results. With at-home kits, you can determine your blood type in just a few minutes. EldonCard 3. At-home blood test At-home tests are relatively straightforward. You will usually start by wiping your finger with an alcohol wipe and then be required to prick your finger with a disposable lancet to draw blood. Then, you will wipe blood on the provided card. Depending on how the blood dries, clumps or spreads, you will be able to compare your blood stain to a results card. Within minutes, you'll be able to determine your blood type. For more, try these seven methods for sneaking more exercise into your daily routine.
CNET
12-05-2025
- Health
- CNET
Find Your Blood Type With These 3 Simple Methods
When you think of medical information you probably don't immediately consider your blood type. However, more than 1-in-3 Americans don't know their blood type. This can put you in danger, especially if you're in a medical emergency where you require a blood transfusion. Along with emergencies, your blood type also has a huge impact on your health affecting everything from heart health, to a predisposition for conditions like type 2 diabetes. Two years ago, I was filling out an application to volunteer at a children's hospital and on the form, I was asked to provide my blood type. Luckily, I knew that I'm type O-positive, but I wanted documentation to confirm this information. I called my mom to see if blood type is listed on my birth certificate -- no luck. I checked my physician's health portal -- also no luck. This got me wondering: How does someone discover their blood type if they don't already know it? The good news is that finding out your blood type is relatively simple, and you have options. Below are three easy ways to find out your blood type. Blood type basics CNET Blood type is categorized into one of these eight groups: A-positive, A-negative, B-positive, B-negative, O-positive, O-negative, AB-positive and AB-negative. But what determines blood type and what does that blood type mean? Blood types are determined by antigens -- a substance that triggers an immune response -- on the surface of red blood cells. There are ABO antigens, which designate ABO blood types. This is determined by the ABO gene. For example: Type A blood type has the A antigen blood type has the A antigen Type B blood type has the B antigen blood type has the B antigen Type AB blood type has both the A and B antigen blood type has both the A and B antigen Type O doesn't produce any A or B antigen There are also Rhesus (Rh) antigens, which determine if blood is "positive" or "negative." If you have Rh proteins on the surface of your red blood cells, you are Rh positive. If you don't have Rh proteins on the surface of your red blood cells, you have negative blood. Blood type is categorized into one of these eight groups: A-positive, A-negative, B-positive, B-negative, O-positive, O-negative, AB-positive and AB-negative. Ekachai Lohacamonchai/EyeEm/Getty Images How to find your blood type? Here's three main ways to type your blood: Have your doctor do a blood test Donate blood Use an at-home blood test 1. Clinical test One of the easiest and most effective ways to determine your blood type is to have your doctor perform a test. A professional will draw blood and then perform two tests on the blood sample: forward typing and reverse typing. During forward typing, the blood sample is mixed with antibodies against type A and B blood. Based on whether the blood cells stick together when mixed with the antibodies, your blood type can be determined from there. If your blood cells stick together when mixed with antibodies against type B blood, you have type B blood. If your blood cells stick together when mixed with antibodies against type A blood, you have type A blood. To confirm the result, the next step is reverse typing, meaning the blood sample without red blood cells -- called a serum -- is mixed with type A and type B blood cells. Type A blood will have antibodies against Type B blood in the sample and type B blood will have antibodies against Type A blood. Type O blood will contain antibodies against Type A and Type B. So, if sticking occurs when the serum is mixed with type B blood cells, you have type A blood, and if sticking occurs when the serum is mixed with type A blood cells, you have type B blood. I recommend calling your doctor's office to see what a blood type test costs out-of-pocket and if it's covered by insurance. 2. Donate blood This is an easy -- and free -- way to determine blood type, but results are not immediate. If you donate to a blood drive, you can simply ask the staff about your blood type. Blood usually is not tested right away, so it may take up to a few weeks to get the results. With at-home kits, you can determine your blood type in just a few minutes. EldonCard 3. At-home blood test At-home tests are relatively straightforward. You will usually start by wiping your finger with an alcohol wipe and then be required to prick your finger with a disposable lancet to draw blood. Then, you will wipe blood on the provided card. Depending on how the blood dries, clumps or spreads, you will be able to compare your blood stain to a results card. Within minutes, you'll be able to determine your blood type. For more, try these seven methods for sneaking more exercise into your daily routine.
