AUTHOR=Hamilton Matthew J. , Greene Loren W. , Madigan Lauren M. , Wang Sa A. , Arana Yi Cecilia , Kuykendall Andrew , George Tracy I. , Castells Mariana C. 

TITLE=Case Report: Multidisciplinary management of a patient with indolent systemic mastocytosis and refractory symptoms

JOURNAL=Frontiers in Allergy

VOLUME=Volume 5 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/allergy/articles/10.3389/falgy.2024.1401187

DOI=10.3389/falgy.2024.1401187

ISSN=2673-6101

ABSTRACT=Systemic mastocytosis (SM) is a rare hematologic condition characterized by the proliferation and accumulation in tissue of clonal mast cells in multiple organ systems. The release of mast cell mediators in the indolent disease type and the predominant mast cell infiltration of tissues in advanced disease contribute to the heterogeneous clinical presentation. The disease driver in >90% of adult cases is an activating KIT mutation, with D816V being the most frequent. Here we describe a case of a young adult male presenting with osteoporosis with associated symptoms of reflux and a history of bee sting anaphylaxis. A multidisciplinary approach to the diagnosis and management was required to minimize morbidities and prevent complications. Current best supportive care was inadequate to control the patient's disease, and a selective KIT D816V inhibitor (avapritinib) was initiated. Conventional, and advanced therapies, including those in the treatment pipeline for SM are discussed.