Comparación de Luspatercept Y Eritropoyetina en el tratamiento de pacientes con síndrome mielodisplásico de bajo riesgo: revisión sistemática

Abstract

Objective: To synthesize the available scientific evidence on the efficacy of luspatercept versus erythropoietin in the treatment of low-risk MDS. Methodology: A systematic review was conducted following the PRISMA 2020 guidelines. The databases PubMed, Taylor & Francis, and Scopus were searched for studies published between 2020 and 2025. Randomized clinical trials and observational studies evaluating erythroid response, transfusion independence, and adverse effects were included. The risk of bias was assessed using the RoB 2 and JBI tools. Results: Sixteen studies were included. Luspatercept showed greater efficacy than erythropoietin, with erythroid response rates of up to 74.5% and transfusion independence in patients refractory to ESAs. Adverse events were mild to moderate, with no significant increase in progression to acute myeloid leukemia. Discussion: Despite methodological variability and a moderate risk of bias, results were consistent. Luspatercept demonstrated clinical superiority over erythropoietin in refractory settings. Conclusion: Luspatercept represents an effective alternative to erythropoietin in the treatment of low-risk MDS, with an acceptable safety profile, particularly benefiting patients who are refractory or carry mutations such as SF3B1.