Comparison of Hemanext ONE® System and Conventional Red Blood Cell Transfusion

Inclusion Criteria: * Male or female aged 18 or older * Patients with a documented diagnosis of a haematological malignancy requiring chronic transfusions. * If MDS patient, Have low risk or intermediate risk MDS per either IPSS-R (https://www.mds-foundation.org/ipss-r-calculator/) or IPSS-M (IPSS-M Risk Calculator (mds-risk-model.com)) * If MDS patient, a bone marrow aspirate completed within the 6 months prior to study enrolment, and which did not show progression to higher risk MDS * Have RBC transfusion dependence (at least 2 RBC units /8 weeks during the last 16 weeks) * Baseline RBC transfusion threshold of 9 g/dL * ECOG (Eastern Cooperative Oncology Group) performance status \< 3 * Have signed the informed consent form and are willing to comply with the study visits and procedures * If on Iron Chelation Therapy, have been on a stable dose for ≥3 months prior to screening Exclusion Criteria: * Have a life expectancy of less than 1 year * Have palpable splenomegaly (more than 3 cm below the mid clavicular line) * Have other associated causes of anemia (including auto-immune hemolysis or active hemorrhage, or progression to acute leukemia) * If prescribed erythropoiesis affecting disease modifying agents (e.g. G-CSF, erythropoietin), have not been on a stable dose for 90 days * Is currently taking Luspatercept or other investigational erythropoiesis affecting disease modifying agent * Have severe renal insufficiency with creatinine clearance (MDRD or CKD EPI) below 30ml/min * Have lung disease with hypoxia or oxygen-dependent * Have severe coronary artery disease (including unstable angina or recent myocardial infraction) or severe heart failure (left ventricular ejection fraction less than 30%) * Have a history of cancer active in the previous 3 years, except local cervix cancer, or basal cell cutaneous carcinoma * Have a history of allo-immunization other than rhesus Kell that cannot be managed by the local blood bank * Are a female of child-bearing potential that is pregnant, planning to become pregnant in the next 14 months or breastfeeding * Are a patient under guardianship or curatorship * Are currently participating in another interventional study evaluating an erythropoiesis affecting disease modifying agent