Mast cell leukemia medical therapy
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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.
Medical Therapy
Therapeutic approaches are limited and consist of reducing the tumor burden and conservation of organ functions.
Corticosteroids
- Corticosteroids have been recommended as a short term use in combination with cytotoxic drugs.
- It could also be beneficial in some situations such as:
- Malabsorption
- Ascites
- Anaphylaxis
Interferon-α
Interferon-α reduces the frequency of:
- 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.
Cladribine
Cladribine has been used in rare cases of mast cell leukemia with relatively small or no efficacy.
Imatinib
Imatinib does not have direct effect on the D816V KIT mutation, but it may affect other sporadic mutations.
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.
Nilotinib Masatinib Midostaurin