Mast cell leukemia medical therapy: Difference between revisions

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{{CMG}};{{AE}}{{NM}}
{{CMG}};{{AE}}{{NM}}
==Overview==
==Overview==
The mainstay of therapy for symptomatic mast cell leukemia patients is immunochemotherapy.<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref>
The mainstay of therapy for symptomatic mast cell leukemia patients is immunochemotherapy.<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref><ref name="Georgin-LavialleLhermitte2012">{{cite journal|last1=Georgin-Lavialle|first1=S.|last2=Lhermitte|first2=L.|last3=Dubreuil|first3=P.|last4=Chandesris|first4=M.-O.|last5=Hermine|first5=O.|last6=Damaj|first6=G.|title=Mast cell leukemia|journal=Blood|volume=121|issue=8|year=2012|pages=1285–1295|issn=0006-4971|doi=10.1182/blood-2012-07-442400}}</ref>
==Medical Therapy==
==Medical Therapy==
Therapeutic approaches are limited and consist of reducing the tumor burden and conservation of organ functions.
Therapeutic approaches are limited and consist of reducing the tumor burden and conservation of organ functions.<ref name="Georgin-LavialleLhermitte2012">{{cite journal|last1=Georgin-Lavialle|first1=S.|last2=Lhermitte|first2=L.|last3=Dubreuil|first3=P.|last4=Chandesris|first4=M.-O.|last5=Hermine|first5=O.|last6=Damaj|first6=G.|title=Mast cell leukemia|journal=Blood|volume=121|issue=8|year=2012|pages=1285–1295|issn=0006-4971|doi=10.1182/blood-2012-07-442400}}</ref>
===Corticosteroids===
===Corticosteroids===
*Corticosteroids have been recommended as a short term use in combination with cytotoxic drugs.<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref>
*Corticosteroids have been recommended as a short term use in combination with cytotoxic drugs.<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref><ref name="Georgin-LavialleLhermitte2012">{{cite journal|last1=Georgin-Lavialle|first1=S.|last2=Lhermitte|first2=L.|last3=Dubreuil|first3=P.|last4=Chandesris|first4=M.-O.|last5=Hermine|first5=O.|last6=Damaj|first6=G.|title=Mast cell leukemia|journal=Blood|volume=121|issue=8|year=2012|pages=1285–1295|issn=0006-4971|doi=10.1182/blood-2012-07-442400}}</ref>
*It could also be beneficial in some situations such as:
*It could also be beneficial in some situations such as:
:*Malabsorption
:*Malabsorption
Line 13: Line 13:
:*Anaphylaxis
:*Anaphylaxis
===Interferon-α===
===Interferon-α===
Interferon-α reduces the frequency of:<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref>
Interferon-α reduces the frequency of:<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref><ref name="Georgin-LavialleLhermitte2012">{{cite journal|last1=Georgin-Lavialle|first1=S.|last2=Lhermitte|first2=L.|last3=Dubreuil|first3=P.|last4=Chandesris|first4=M.-O.|last5=Hermine|first5=O.|last6=Damaj|first6=G.|title=Mast cell leukemia|journal=Blood|volume=121|issue=8|year=2012|pages=1285–1295|issn=0006-4971|doi=10.1182/blood-2012-07-442400}}</ref>
*Histamine related attacks
*Histamine related attacks
*Decrease bone marrow infiltration by mast cells
*Decrease bone marrow infiltration by mast cells
Line 20: Line 20:
*Improve osteoporosis
*Improve osteoporosis
===2-Chloro-deoxy-adenosine===
===2-Chloro-deoxy-adenosine===
2-Chloro-deoxy-adenosine has a potential value in the treatment of mast cell leukemia with symptomatic responses and improvement in mast cell variables.<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref>
2-Chloro-deoxy-adenosine has a potential value in the treatment of mast cell leukemia with symptomatic responses and improvement in mast cell variables.<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref><ref name="Georgin-LavialleLhermitte2012">{{cite journal|last1=Georgin-Lavialle|first1=S.|last2=Lhermitte|first2=L.|last3=Dubreuil|first3=P.|last4=Chandesris|first4=M.-O.|last5=Hermine|first5=O.|last6=Damaj|first6=G.|title=Mast cell leukemia|journal=Blood|volume=121|issue=8|year=2012|pages=1285–1295|issn=0006-4971|doi=10.1182/blood-2012-07-442400}}</ref>
===Cladribine===
===Cladribine===
Cladribine has been used in rare cases of mast cell leukemia with relatively small or no efficacy.<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref>
Cladribine has been used in rare cases of mast cell leukemia with relatively small or no efficacy.<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref><ref name="Georgin-LavialleLhermitte2012">{{cite journal|last1=Georgin-Lavialle|first1=S.|last2=Lhermitte|first2=L.|last3=Dubreuil|first3=P.|last4=Chandesris|first4=M.-O.|last5=Hermine|first5=O.|last6=Damaj|first6=G.|title=Mast cell leukemia|journal=Blood|volume=121|issue=8|year=2012|pages=1285–1295|issn=0006-4971|doi=10.1182/blood-2012-07-442400}}</ref>
===Imatinib===
===Imatinib===
Imatinib does not have direct effect on the D816V ''KIT'' mutation, but it may affect other sporadic mutations.<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref>
Imatinib does not have direct effect on the D816V ''KIT'' mutation, but it may affect other sporadic mutations.<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref><ref name="Georgin-LavialleLhermitte2012">{{cite journal|last1=Georgin-Lavialle|first1=S.|last2=Lhermitte|first2=L.|last3=Dubreuil|first3=P.|last4=Chandesris|first4=M.-O.|last5=Hermine|first5=O.|last6=Damaj|first6=G.|title=Mast cell leukemia|journal=Blood|volume=121|issue=8|year=2012|pages=1285–1295|issn=0006-4971|doi=10.1182/blood-2012-07-442400}}</ref>
===Dasatinib===
===Dasatinib===
Dasatinib demonstrates significant inhibitory activity against WT ''KIT'' as well as juxtamembrane domain mutant ''KIT''. This activity has been proven in patients negative for D816V ''KIT''.<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref>
Dasatinib demonstrates significant inhibitory activity against WT ''KIT'' as well as juxtamembrane domain mutant ''KIT''. This activity has been proven in patients negative for D816V ''KIT''.<ref name="JorisGeorgin-Lavialle2012">{{cite journal|last1=Joris|first1=Magalie|last2=Georgin-Lavialle|first2=Sophie|last3=Chandesris|first3=Marie-Olivia|last4=Lhermitte|first4=Ludovic|last5=Claisse|first5=Jean-François|last6=Canioni|first6=Danielle|last7=Hanssens|first7=Katia|last8=Damaj|first8=Gandhi|last9=Hermine|first9=Olivier|last10=Hamidou|first10=Mohammed|title=Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive|journal=Case Reports in Hematology|volume=2012|year=2012|pages=1–6|issn=2090-6560|doi=10.1155/2012/517546}}</ref><ref name="Georgin-LavialleLhermitte2012">{{cite journal|last1=Georgin-Lavialle|first1=S.|last2=Lhermitte|first2=L.|last3=Dubreuil|first3=P.|last4=Chandesris|first4=M.-O.|last5=Hermine|first5=O.|last6=Damaj|first6=G.|title=Mast cell leukemia|journal=Blood|volume=121|issue=8|year=2012|pages=1285–1295|issn=0006-4971|doi=10.1182/blood-2012-07-442400}}</ref>


Nilotinib
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Revision as of 19:29, 1 December 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]

Overview

The mainstay of therapy for symptomatic mast cell leukemia patients is immunochemotherapy.[1][2]

Medical Therapy

Therapeutic approaches are limited and consist of reducing the tumor burden and conservation of organ functions.[2]

Corticosteroids

  • Corticosteroids have been recommended as a short term use in combination with cytotoxic drugs.[1][2]
  • It could also be beneficial in some situations such as:
  • Malabsorption
  • Ascites
  • Anaphylaxis

Interferon-α

Interferon-α reduces the frequency of:[1][2]

  • Histamine related attacks
  • Decrease bone marrow infiltration by mast cells
  • Decrease liver infiltration by mast cells
  • Decrease skin manifestations
  • Improve osteoporosis

2-Chloro-deoxy-adenosine

2-Chloro-deoxy-adenosine has a potential value in the treatment of mast cell leukemia with symptomatic responses and improvement in mast cell variables.[1][2]

Cladribine

Cladribine has been used in rare cases of mast cell leukemia with relatively small or no efficacy.[1][2]

Imatinib

Imatinib does not have direct effect on the D816V KIT mutation, but it may affect other sporadic mutations.[1][2]

Dasatinib

Dasatinib demonstrates significant inhibitory activity against WT KIT as well as juxtamembrane domain mutant KIT. This activity has been proven in patients negative for D816V KIT.[1][2]

Nilotinib Masatinib Midostaurin

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Joris, Magalie; Georgin-Lavialle, Sophie; Chandesris, Marie-Olivia; Lhermitte, Ludovic; Claisse, Jean-François; Canioni, Danielle; Hanssens, Katia; Damaj, Gandhi; Hermine, Olivier; Hamidou, Mohammed (2012). "Mast Cell Leukaemia: c-KIT Mutations Are Not Always Positive". Case Reports in Hematology. 2012: 1–6. doi:10.1155/2012/517546. ISSN 2090-6560.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Georgin-Lavialle, S.; Lhermitte, L.; Dubreuil, P.; Chandesris, M.-O.; Hermine, O.; Damaj, G. (2012). "Mast cell leukemia". Blood. 121 (8): 1285–1295. doi:10.1182/blood-2012-07-442400. ISSN 0006-4971.
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