Follow-Up of 3-Year Luspatercept Treatment in a Transfused ß-Thalassemia Patient. Bone Marrow: An Undervalued Iron Store.

Introduction: Treatment with luspatercept may improve transfusion requirements in transfusion-dependent thalassemia (TDT), but the improved erythroid maturation in the bone marrow influences body iron distribution. Case Report: We report on sequential organ iron measurements in a TDT patient under luspatercept treatment. Despite a decline in transfusion requirement and ferritin, we observed a redistribution of body iron stores from spleen and bone marrow to the liver, increasing liver iron concentration (LIC). Conclusion: Luspatercept treatment affects the informative value of ferritin and LIC in the assessment of total body iron stores, which should be considered in the management of iron chelation therapy.