For patients who undergo multiple transfusions with lower-risk myelodysplastic syndromes (LR-MDS) that are not responding to or are ineligible for erythropoiesis-stimulating agents (ESAs), the competitive telomerase inhibitor imetelstat leads to durable red blood cell (RBC) transfusion independence, according to a study published in The Lancet. A research team compared the RBC transfusion independence rate with imetelstat versus placebo in patients with RBC transfusion-dependent LR-MDS in a double-blind trial conducted at 118 sites. Overall, 178 patients (aged 18 and older) with ESA-relapsed, ESA-refractory, or ESA-ineligible LR-MDS were enrolled and randomly assigned to imetelstat or placebo (118 and 60, respectively), administered every 4 weeks as a 2-hour IV infusion. Patients were followed for a median of 19.5 and 17.5 months in the imetelstat and placebo groups, respectively. Among patients receiving imetelstat and placebo, 91% and 47%, respectively, had grade 3 to 4 treatment-emergent adverse events, with the most common events being neutropenia and thrombocytopenia for those taking imetelstat