How I diagnose and treat systemic mastocytosis with an associated hematologic neoplasm.

IF 21 1区 医学 Q1 HEMATOLOGY
Blood Pub Date : 2025-01-14 DOI:10.1182/blood.2023022416
Deepti H Radia
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引用次数: 0

Abstract

Over the last decade significant advances have been made by honing in on the diagnostic evaluation and the significance of molecular profiles in patients with systemic mastocytosis (SM), non-advanced and advanced.This is reflected in the 2022 iterations of the World Health Organization Edition 5 and International Consensus Criteria classifications.The impact of targeted KIT inhibitor therapies on patients treated within global trials has demonstrated significant improvements in the prognosis and overall survival for patients, leading to a change the treatment paradigm.Patients with SM and an associated hematologic neoplasm (SM-AHN) comprise of up to 70% of those in the advanced SM category, posing varying challenges in diagnosis and clinical heterogeneity due to the occupation of the bone marrow niche by two hematologic neoplasms.We are constantly learning about the complex, heterogenous genotypic and phenotypic spectrum of these patients with a view to provide personalised treatment options, aiming to improve outcomes, quality of life and ultimately a cure. This paper focuses on the management of patients with advanced systemic mastocytosis with an associated hematologic neoplasm and is a personal perspective using some illustrative patient cases treated at our centre, Guys and St Thomas's Hospitals, London: UK centre of excellence in Mastocytosis.

我如何诊断和治疗系统性肥大细胞增多症与相关的血液肿瘤。
在过去的十年中,通过对系统性肥大细胞增多症(SM)患者的诊断评估和分子谱的意义的研究取得了重大进展,包括非晚期和晚期。这反映在世界卫生组织第5版和国际共识标准分类的2022年迭代中。在全球试验中,靶向KIT抑制剂治疗对患者的影响已显示出患者预后和总体生存期的显着改善,导致治疗范式的改变。SM和相关血液肿瘤(SM- ahn)患者占晚期SM患者的70%,由于两种血液肿瘤占据骨髓生态位,在诊断和临床异质性方面提出了不同的挑战。我们不断了解这些患者复杂的、异质性的基因型和表型谱,以期提供个性化的治疗方案,旨在改善结果、生活质量并最终治愈。本文的重点是对伴有血液学肿瘤的晚期全身性肥大细胞增多症患者的管理,并从个人的角度使用我们的中心,伦敦盖伊和圣托马斯医院:英国肥大细胞增多症卓越中心治疗的一些病例。
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来源期刊
Blood
Blood 医学-血液学
CiteScore
23.60
自引率
3.90%
发文量
955
审稿时长
1 months
期刊介绍: Blood, the official journal of the American Society of Hematology, published online and in print, provides an international forum for the publication of original articles describing basic laboratory, translational, and clinical investigations in hematology. Primary research articles will be published under the following scientific categories: Clinical Trials and Observations; Gene Therapy; Hematopoiesis and Stem Cells; Immunobiology and Immunotherapy scope; Myeloid Neoplasia; Lymphoid Neoplasia; Phagocytes, Granulocytes and Myelopoiesis; Platelets and Thrombopoiesis; Red Cells, Iron and Erythropoiesis; Thrombosis and Hemostasis; Transfusion Medicine; Transplantation; and Vascular Biology. Papers can be listed under more than one category as appropriate.
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