Luspatercept in Transfusion-Dependent Thalassemia With Red Blood Cell Antibodies: A Case Series.

Red blood cell (RBC) antibodies complicate transfusion support in transfusion-dependent thalassemia (TDT), and data on luspatercept in this setting remain limited. We retrospectively reviewed seven adults with TDT and RBC antibodies treated with luspatercept at Srinagarind Hospital from January 2025 to January 2026. Baseline transfusion need was six packed RBC units/12 weeks in all patients. During weeks 13-24, six patients achieved a clinically meaningful reduction, with a median decrease of three units/12 weeks (range, 2-5; median 50.0%). Responses were greatest without warm autoantibodies. No new alloantibodies or serious adverse events were observed. Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.