Acute splenomegaly, haemolysis, and thrombocytopenia following luspatercept initiation in a patient with transfusion-dependent thalassaemia: A case report.

Patients with transfusion-dependent thalassaemia (TDT) require chronic, life-sustaining red blood cell transfusions, which contribute to iron overload and associated morbidity and mortality. Luspatercept, an inhibitor of the transforming growth factor-beta pathway, decreases transfusion requirements in a subset of transfusion-dependent β-thalassaemia patients and is increasingly prescribed in clinical practice. Subsequent to regulatory approvals, several reports have identified the risk of extra-medullary haematopoiesis, which resulted in updated safety labelling. In this report, we present a case of a patient with TDT who developed severe splenomegaly, haemolysis and thrombocytopenia necessitating treatment discontinuation.