Are you now using luspatercept as your first choice for anemia management in patients with low-risk MDS otherwise appropriate for EPO initiation, regardless of presence of SF3B1 or ringed sideroblasts?  

Only use luspatercept if the patient is transfusion-dependent. FDA approves luspatercept as first-line treatment of anemia in adults with lower-risk MDS (aabb.org). In patients with MDS who are candidates for epo and transfusion independent then epo is still my first choice.