Document Detail


Systemic mastocytosis: bone marrow pathology, classification, and current therapies.
MedLine Citation:
PMID:  15995324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mast cell disease (MCD) is characterized by the abnormal growth and accumulation of neoplastic mast cells (MC) in one or more organs. The diagnosis of systemic MCD is most commonly established by a thorough histological and immunohistochemical examination of a bone marrow (BM) trephine specimen. In cases with pathognomonic perivascular and -trabecular aggregates of morphologically atypical MC and significant BM involvement, the diagnosis may be relatively straightforward. In contrast, when a sparse, loose pattern of MC infiltration predominates, or when MCs are obscured by an associated non-MC hematological neoplasm, a high index of suspicion and use of adjunctive tests, including special stains, such as tryptase and CD25, may be necessary to reach a diagnosis. The updated classification for MCD clarifies the clinical and pathological criteria for categorizing patients into relatively discrete subgroups. Some cases, however, such those with Fip1-like-1-platelet-derived growth factor receptor alpha (FIP1L1-PDGFRA)(+) clonal eosinophilia associated with elevated serum tryptase levels, with features that overlap MCD and chronic eosinophilic leukemia, may not be easy to categorize on the basis of this classification. There is no standard therapy for MCD and treatment has to be tailored to the needs of the individual patient. MC-cytoreductive therapies, such as interferon-alpha and chemotherapy, are generally reserved for patients with progressive disease and organopathy. A subset of MCD patients with associated eosinophilia who carry the FIP1L1-PDGFRA oncogene will achieve complete clinical, histological, and molecular remissions with imatinib mesylate therapy, in contrast to those with c-kit D816V mutations. The BM pathology, consensus classification, and current therapies for MCD are further discussed in this article.
Authors:
A Pardanani
Related Documents :
22535264 - Adverse effect of early epileptic seizures in patients receiving endovascular therapy f...
20425444 - Diagnosis and management of chronic myelomonocytic leukemia.
10400374 - Tailoring the treatment of acute myeloid leukemia.
12189644 - High incidence of cd56 expression and relapse rate in acute myeloid leukemia patients w...
17054764 - Early dental management of patients with mobius syndrome.
20061834 - Peripherally inserted central venous catheters and central venous catheters in burn pat...
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Acta haematologica     Volume:  114     ISSN:  0001-5792     ISO Abbreviation:  Acta Haematol.     Publication Date:  2005  
Date Detail:
Created Date:  2005-07-04     Completed Date:  2005-08-04     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0141053     Medline TA:  Acta Haematol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  41-51     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2005 S. Karger AG, Basel.
Affiliation:
Divisions of Hematology and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Pardanani.animesh@mayo.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents / therapeutic use
Bone Marrow / pathology*
Humans
Interferon-alpha / therapeutic use
Mastocytosis, Systemic / classification*,  pathology*,  therapy*
Oncogene Proteins, Fusion
Piperazines / therapeutic use
Pyrimidines / therapeutic use
Receptor, Platelet-Derived Growth Factor alpha / analysis
Receptors, Interleukin-2 / analysis
Serine Endopeptidases / analysis
Tryptases
mRNA Cleavage and Polyadenylation Factors / analysis
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/FIP1L1-PDGFRA fusion protein, human; 0/Interferon-alpha; 0/Oncogene Proteins, Fusion; 0/Piperazines; 0/Pyrimidines; 0/Receptors, Interleukin-2; 0/mRNA Cleavage and Polyadenylation Factors; 152459-95-5/imatinib; EC 2.7.10.1/Receptor, Platelet-Derived Growth Factor alpha; EC 3.4.21.-/Serine Endopeptidases; EC 3.4.21.59/Tryptases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Interferon treatment for hypereosinophilic syndromes and systemic mastocytosis.
Next Document:  Modern diagnosis and treatment of primary eosinophilia.