[The efficacy and safety of luspatercept in promoting the recovery of erythropoiesis after allogeneic hematopoietic stem cell transplantation].

A retrospective study was conducted on the patients with hematological disease who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) at Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between February 2023 and July 2024. The patients were divided into the luspatercept group and the control group according to whether luspatercept was administered after allo-HSCT. The luspatercept group was further subdivided into the matched group and the mismatched group according to ABO blood group compatibility between the donor and recipient, to compare the recovery of hematopoietic function before and after treatment in each group.The luspatercept group included 39 patients [18 males and 21 females; aged (47±13) years], and the control group included 94 patients [53 males and 41 females; aged (44±13) years]. In the luspatercept group, the hemoglobin (Hb) rose from (54.0±10.2) g/L at baseline to (95.8±19.7) g/L 21 days later, with 84.6% (33/39) of patients achieving an erythroid response (Hb increase≥20 g/L). Among luspatercept-treated patients, 17 were ABO-matched and 22 were ABO-mismatched. The baseline and day-21 Hb levels did not differ significantly between both groups (both P>0.05). Although the baseline Hb level was higher in the control group than that in the luspatercept group [(75.2±13.4) vs (54.0±10.2) g/L, P<0.001], there was no statistically significant difference in Hb levels between the two groups after 21 days of treatment (P=0.392). One-year overall survival and disease-free survival in the luspatercept group were 84.1% and 81.5%, respectively, while those in the control group were 92.9% and 88.6%. The differences in one-year overall survival and disease-free survival were not statistically significant (both P>0.05). Adverse events in the luspatercept group were predominantly grade 1-2, inclued diarrhea, nausea, and hypertension. Early administration of luspatercept after allo-HSCT can safely accelerate erythroid recovery.