Geron Logo

Please complete the Safety Event report below

This adverse event report form is available to report an adverse event or other special situation event, including pregnancy; overdose; suspected abuse/misuse; inadvertent or accidental exposure; medication error; lack of effect, use of Rytelo (Imetelstat) with pediatric or elderly population (or “use of Rytelo (Imetelstat) in age groups outside the age range approved within the product label” OR “off-label use”), exposure to Imetelstat during breastfeeding that occurred during or after treatment with Imetelstat.

Note: If the patient experiencing the adverse event is participating in an active Geron Imetelstat clinical trial, please contact your investigative site to report an adverse event.

For General information about Geron, please click here.

Your data will not be shared with unauthorized 3rd parties.

Fields marked like this * are required to submit a report. Data entry can be performed either by typing or by voice entry by clicking on the microphone icon.