Clinical Insights from IMerge: Interpreting Cytopenias and Long-Term Outcomes with Imetelstat in Lower-Risk MDS

These IMerge trial analyses provide important context for understanding both the short- and long-term effects of imetelstat in patients with lower-risk myelodysplastic syndromes (LR-MDS). The first study evaluated the relationship between treatment-emergent cytopenias and clinical response, demonstrating that early, manageable cytopenias were frequently associated with deeper and more durable hematologic responses, including transfusion independence. This finding supports cytopenias as a potential on-treatment pharmacodynamic marker rather than solely an adverse signal. The second analysis focused on long-term outcomes from the randomized phase 3 IMerge trial, confirming the durability of responses with imetelstat, sustained transfusion independence, and clinically meaningful disease modification over extended follow-up. Together, these studies reinforce the importance of proactive monitoring and management of cytopenias, while highlighting imetelstat’s potential to provide durable benefit beyond symptomatic control in LR-MDS.