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INDICATION

RYTELO® (imetelstat) is indicated for the treatment of adult patients with low- to intermediate-1 risk myelodysplastic syndromes (MDS) with transfusion-dependent anemia requiring 4 or more red blood cell units over 8 weeks who have not responded to or have lost response to or are ineligible for erythropoiesis-stimulating agents (ESA). See more

In second-line LR-MDS,

give your eligible* patients

THE POSSIBILITY OF

ZERO TRANSFUSIONS1


*ESA-ineligible or relapsed/refractory patients requiring ≥4 RBC units/8 weeks. In the IMerge trial, 39.8% (n=47/118) of these patients achieved RBC-TI for ≥8 consecutive weeks vs 15% (n=9/60) with placebo (P<0.001).1,2,†

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Recommendation
Imetelstat (RYTELO®) is an nccn category 1, preferred second-line treatment option for LR-MDS, symptomatic anemia in eligible* RS- and RS+ patients3,‡
The FIRST and ONLY FDA-APPROVED treatment
for transfusion-dependent anemia in LR-MDS after ESAs for use in RS- patients 1,4-8

ESA, erythropoiesis-stimulating agent; HMA, hypomethylating agent; IPSS, International Prognostic Scoring System; IPSS-R, Revised International Prognostic Scoring System; LR-MDS, lower-risk myelodysplastic syndromes; MDS, myeloplastic syndromes; NCCN, National Comprehensive Cancer Network; RBC, red blood cell; RBC-TI, red blood cell transfusion independence; RS, ring sideroblasts; sEPO, serum erythropoietin.

Study design: IMerge was a phase 3, double-blind, placebo-controlled clinical trial evaluating patients with ESA-relapsed, ESA-refractory, or ESA-ineligible LR-MDS (low or intermediate-1 as per IPSS criteria). Patients were randomized 2:1 to receive RYTELO (n=118) or placebo (n=60) and had not received prior treatment with either an HMA or lenalidomide and were non-del(5q). Supportive care, including RBC and platelet transfusions, myeloid growth factors, and iron chelation therapy, was administered as needed per investigator discretion.
For certain patients with IPSS-R very low-, low-, or intermediate-risk MDS with non-del(5q) ± other cytogenetic abnormalities, with sEPO ≤500 mU/mL, and with either RS <15% (or RS <5% with an SF3B1 mutation) or RS ≥15% (or RS ≥5% with an SF3B1 mutation).

References: 1. RYTELO. Prescribing information. Geron Corp.; 2024. 2. Platzbecker U and Santini V, et al. Imetelstat in patients with lower-risk myelodysplastic syndromes who have relapsed or are refractory to erythropoiesis-stimulating agents (IMerge): a multinational, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2024;403(10423):249-260. 3. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Myelodysplastic Syndromes V.3.2026. © National Comprehensive Cancer Network, Inc. 2026. All rights reserved. Accessed January 12, 2026. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. 4. REBLOZYL. Prescribing information. Bristol-Myers Squibb Company; 2023. 5. REVLIMID. Prescribing information. Bristol-Myers Squibb Company; 2023. 6. VIDAZA. Prescribing information. Bristol-Myers Squibb Company; 2024. 7. INQOVI. Prescribing information. Taiho Pharmaceutical Co.; 2024. 8. DACOGEN. Prescribing information. Astex Pharmaceuticals, Inc.; 2018.

INDICATION

RYTELO® (imetelstat) is indicated for the treatment of adult patients with low- to intermediate-1 risk myelodysplastic syndromes (MDS) with transfusion-dependent anemia requiring 4 or more red blood cell units over 8 weeks who have not responded to or have lost response to or are ineligible for erythropoiesis-stimulating agents (ESA).

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS

Thrombocytopenia

RYTELO® can cause thrombocytopenia based on laboratory values. In the clinical trial, new or worsening Grade 3 or 4 decreased platelets occurred in 65% of patients with MDS treated with RYTELO.

Monitor patients with thrombocytopenia for bleeding. Monitor complete blood cell counts prior to initiation of RYTELO, weekly for the first two cycles, prior to each cycle thereafter, and as clinically indicated. Administer platelet transfusions as appropriate. Delay the next cycle and resume at the same or reduced dose, or discontinue as recommended.

Neutropenia

RYTELO can cause neutropenia based on laboratory values. In the clinical trial, new or worsening Grade 3 or 4 decreased neutrophils occurred in 72% of patients with MDS treated with RYTELO.

Monitor patients with Grade 3 or 4 neutropenia for infections, including sepsis. Monitor complete blood cell counts prior to initiation of RYTELO, weekly for the first two cycles, prior to each cycle thereafter, and as clinically indicated. Administer growth factors and anti-infective therapies for treatment or prophylaxis as appropriate. Delay the next cycle and resume at the same or reduced dose, or discontinue as recommended.

Infusion-Related Reactions

RYTELO can cause infusion-related reactions. In the clinical trial, infusion-related reactions occurred in 8% of patients with MDS treated with RYTELO; Grade 3 or 4 infusion-related reactions occurred in 1.7%, including hypertensive crisis (0.8%). The most common infusion-related reaction was headache (4.2%). Infusion-related reactions usually occur during or shortly after the end of the infusion.

Premedicate patients at least 30 minutes prior to infusion with diphenhydramine and hydrocortisone as recommended and monitor patients for at least one hour following the infusion as recommended. Manage symptoms of infusion-related reactions with supportive care and infusion interruptions, decrease infusion rate, or permanently discontinue as recommended.

Embryo-Fetal Toxicity

Based on animal findings, RYTELO can cause embryo-fetal harm when administered to a pregnant woman. Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment with RYTELO and for 1 week after the last dose.

ADVERSE REACTIONS

Serious adverse reactions occurred in 32% of patients who received RYTELO. Serious adverse reactions in >2% of patients included sepsis (4.2%), fracture (3.4%), cardiac failure (2.5%), and hemorrhage (2.5%). Fatal adverse reactions occurred in 0.8% of patients who received RYTELO, including sepsis (0.8%).

Most common adverse reactions (≥10% with a difference between arms of >5% compared to placebo), including laboratory abnormalities, were decreased platelets, decreased white blood cells, decreased neutrophils, increased AST, increased alkaline phosphatase, increased ALT, fatigue, prolonged partial thromboplastin time, arthralgia/myalgia, COVID-19 infections, and headache.

Please see full Prescribing Information, including Medication Guide.

You are encouraged to report adverse events related to Geron products by calling 1-855-437-6664 (1-855-GERON-MI) (US only). If you prefer, you may contact the US Food and Drug Administration (FDA) directly. Visit www.fda.gov/MedWatch or call 1-800-FDA-1088.