Interesting Continuing Education item

[jayfish101]

Interesting item I excerpted from a continuing education quiz for doctors that I received via Clinical Care Options and Amer Zeidan
MBBS, MPH
A patient with lower-risk non-del(5q) MDS has been requiring approximately 4 units of RBCs every 4 weeks for the past 6 months. Iron studies, platelets, and white blood cell counts have been within normal limits. During this time, she has been maintained on epoetin alfa 60,000 units twice weekly with no change in hemoglobin concentration.

In addition to monitoring, what would be the next recommended step for her management?

A
10.5%
Continue epoetin alfa

B
19.9%
Increase epoetin alfa

C
36.5%
Change to azacitidine

D
13.3%
Change to eltanexor (clinical trial)

E
19.9%
Change to imetelstat (clinical trial)

Your Answer: E
Correct Answer: E

[biopearl123]

Every reader of this board should know or should have known what the correct answer was.

[rccola335]

i think as imetelstat is used and practitioners become comfortable and see the significant HgB increase its market share will keep increasing

[rccola335]

and of course the question is - how can that be the answer for a drug that is not approved

[biopearl123]

You have not taken too many medical tests I guess. When there is no other right answers but enrollment in a trial is an option, that’s usually it. The drug trial is still enrolling and would offer this hypothetical patient the best approach.Totally legit test question.