How to take Rytelo (Imetelstat)

Rytelo (Imetelstat) is a first-in-class treatment that works by inhibiting the enzymatic activity of telomerase and is indicated for the treatment of adult patients with low-to-moderate risk myelodysplastic syndrome (MDS) who have transfusion-dependent anemia, require 4 or more red blood cell units for more than 8 weeks, and are unresponsive or ineligible for an erythropoiesis-stimulating agent (ESA). In LR-MDS, abnormal bone marrow cells often express telomerase, an enzyme that rebuilds those telomeres, allowing uncontrolled cell division.

1. Recommended dose: The recommended dose of Rytelo is 7.1mg/kg, intravenously infused for 2 hours every 4 weeks. RYTELO should be discontinued if the patient does not experience a reduction in red blood cell (RBC) transfusions after 24 weeks of treatment (6 doses) or if unacceptable toxicity occurs at any time.

2. Recommended premedication: At least30 minutes before administration. Patients may need to take the following pretreatment medications to prevent or reduce potential infusion-related reactions: Diphenhydramine (or equivalent) 25 mg to 50mg intravenously or orally; hydrocortisone (or equivalent) 100mg to 200mg intravenously or orally; monitor patients for adverse reactions for at least one hour after completion of infusion.

3. Dose adjustment: Patients may experience intolerable adverse reactions after using Rytelo. The doctor will temporarily delay the dose, reduce the dose or stop treatment according to the severity of the condition. The initial dose can be reduced to 5.6 once every 4 weeks pan>mg/kg; The second dose can be reduced to 4.4mg/kg every 4 weeks; if the patient cannot tolerate the lowest dose level of 4.4 mg/kg, Rytelo treatment should be permanently discontinued.