Abstracts Clinical Lymphoma, Myeloma & Leukemia September 2024 S390 the American Oncology Network. Eligible patients were aged ≥18 years, diagnosed with LR-MDS, prescribed ≥1 dose of luspatercept, and had ≥3 months of follow-up. Luspatercept was initiated May 1, 2020-February 21, 2022, in the no-EMR alert cohort (cohort 1) and February 22, 2022-July 31, 2023, in the EMR-alert cohort (cohort 2). Outcomes included evaluation of dose escalations (inappropriate dose escalations were outside 1.0, 1.33, or 1.75 mg/ kg), rounding of prescribed dose to the nearest vial, and RBC-TI for ≥8 weeks at weeks 16 and 24 (end of follow-up). Statistical significance was determined using chi-square, Wilcoxon, or Fisher exact t-test. Results: A total of 54 patients were in cohort 1, 38 in cohort 2; baseline characteristics were comparable (median age: 81.0 vs 76.0 years; sex: 53.7% vs 56.4% male; median hemoglobin levels: 8.4 g/dL for both; transfusion dependence [≥1 RBC unit in previous 8 weeks]: 66.7% vs 53.8%; ring sideroblast presence: 77.8% vs 71.8%). In cohort 2, 2.6% of patients vs 33.3% in cohort 1 experienced inappropriate dosing (P=0.0003). Among patients requiring dose escalation (cohort 1, 30; cohort 2, 16), median time to highest dose in the first 24 weeks was 12 vs 15 weeks in cohort 2 vs 1 (P=0.5329). Dose rounding occurred less in cohort 2 vs 1 (53.8% vs 75.9%; P=0.0258), indicating more accurate weightbased dosing. Median drug waste was similar in cohort 2 vs 1 (6.9 vs 7.5 mg; P=0.9008), suggesting dose rounding does not reduce drug waste. In cohort 2 vs 1, 82.1% vs 66.7% (P=0.0987) of patients received maximum luspatercept dose/achieved RBC-TI at week 16. At end of follow-up, 61.5% vs 53.7% (P=0.4514) of patients in cohort 2 vs 1 achieved/maintained RBC-TI. Conclusion: An EMR alert resulted in a higher proportion of patients being appropriately dosed with luspatercept and enabled >80% to reach maximum dose/ achieve RBC-TI. EMR interventions may enhance appropriateness of luspatercept treatment, improving patient outcomes. Keywords: MDS, myelodysplastic syndromes, luspatercept, transfusion independence, dosing alert MDS-242 Correlation Between Myelodysplastic Syndrome and COVID-19 Infection Rana G. Abdelfatah MD, Salma Abdelghany Shawkat MD, Menna Abdelghany Ali MD, Enaam Ali Al Mwafy MD, Nermine Moheb Mettias MD Ain Shams University, Cairo, Egypt Context: The COVID-19 (SARS-CoV-2) pandemic had a variety of effects on patients with hematological malignancies, including diagnostic and therapeutic delays, a lack of blood supplies, and, most critically, increased risks of morbidity and death from the viral infection itself. The effects of COVID-19 on numerous particular tumors have already been detailed; however, nothing has been published on its impact on patients with myelodysplastic syndrome (MDS). Objectives: This study was conducted to evaluate the epidemiology of COVID-19 in MDS patients and to estimate the prevalence of disease severity. Design: The study was a retrospective observational study. Patient and methods: The study included 88 MDS patients whose data was collected from all available medical records who attended the Hematology Department at Ain Shams University in Cairo between January 2020 and December 2022. Main outcome measures: Laboratory-based diagnosis of MDS patients before COVID-19 (eg, age, sex, bone marrow results, risk stratification, prognostic status of MDS, cytogenetic assessment, type of management). Evidence of COVID-19 diagnosis was also evaluated by PCR, chest x-ray, clinical presentations, type of treatment, and vaccination types and doses. Results: A significant association was found between COVID-19 infection and the hematological presentation of the patients (P < .05). Most of our subjects (34 patients [40.5%]) fell under the category of MDSMLD. Significance was found between COVID-19 infection, the classification of MDS, the percentage of blast cells in the marrow, and the degree of dysplasia (P < .001). Significance was also reported between COVID-19 infection and the severity of MDS (P < .05). Regarding cytogenetics, the only relationships were between COVID-19 infection and deletion of chromosome 5, and patients with complex cytogenetic anomalies (P < .01 and P < .03, respectively). Conclusion: There was a strong correlation between COVID-19 infection and MDS severity, with a significant association between COVID-19 infection and the hematological presentation, percentage of blast cells, and the degree of dysplasia. Keywords: MDS, myelodysplasia, COVID-19, MLD MDS-276 Management of Patients with LowerRisk Myelodysplastic Syndromes (LR-MDS) in a Large US Community Oncology Practice: A Focus on Patient Outcomes Post ErythropoiesisStimulating Agent (ESA) Treatment Gustavo Fonseca MD1, Amanda Warner MS, RN1, Amy Ming EDD, MBA, RN, PMP1, Samantha Slaff MS2, Derek Tang PhD, BSPharm2, Nisha Singh PharmD, BCOP2, Svetlana Gavrilov MD, PhD2, Ashley Swanson PhD2, Francis Lobo PhD2, Trevor Heritage PhD1, Ernest Griffin MS1, Lucio Gordan MD1 1Florida Cancer Specialists & Research Institute, Tampa, FL, USA. 2Bristol Myers Squibb, Lawrenceville, NJ, USA Context: ESAs are an established treatment for MDS-related anemia. Data on ESA response and/or failure mostly originate from clinical trials, which may not always reflect real-world clinical practice. Objective: To describe the characteristics of patients with LR-MDS treated with ESAs and treatment patterns following ESA failure. Methods: This study used data from Florida Cancer Specialists & Research Institute (FCS) databases and records of patients with LR-MDS aged ≥18 years treated at FCS 2018–2022, with 1 year of follow-up data from initial diagnosis, ≥6 months of data prior to diagnosis, and LR-MDS defined by International Prognostic Scoring System (IPSS) or revised IPSS. Patients treated with luspatercept prior to ESAs were excluded. ESA failure was defined as patients with <1.5 g/dL increase in hemoglobin (Hb) level or no decrease in red blood cell transfusion (RBCT) requirement by 6–8 weeks of treatment. Results: 359 patients with LR-MDS were included in this analysis. Median age at diagnosis was 79.0 years,
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