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McComish JS, Slade CA, Buizen L, Paul SK, Chatelier JW, Unglik G, Nicholls KA, Spriggs K, Chan SS, Godsell J, Auyeung P, Tan ZH, DeLuca J, Patel M, Kuek LE, Tran Y, Kern JS, Scardamaglia L, Varigos GA, Juneja S, Grabek JA, Christie M, Mackay GA, Douglass JA. Randomized controlled trial of omalizumab in treatment-resistant systemic and cutaneous mastocytosis (ROAM). THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2248-2250.e3. [PMID: 37088371 DOI: 10.1016/j.jaip.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023]
Affiliation(s)
| | - Charlotte A Slade
- Royal Melbourne Hospital, Parkville, Victoria, Australia; Walter and Eliza Hall Institute, Melbourne, Victoria, Australia
| | - Luke Buizen
- Royal Melbourne Hospital, Parkville, Victoria, Australia; Melbourne EpiCentre, University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Sanjoy K Paul
- Royal Melbourne Hospital, Parkville, Victoria, Australia; Melbourne EpiCentre, University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Josh W Chatelier
- Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Gary Unglik
- Royal Melbourne Hospital, Parkville, Victoria, Australia
| | | | - Kymble Spriggs
- Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Samantha S Chan
- Royal Melbourne Hospital, Parkville, Victoria, Australia; Walter and Eliza Hall Institute, Melbourne, Victoria, Australia; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Jack Godsell
- Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Priscilla Auyeung
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - Zi Hao Tan
- Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Joseph DeLuca
- Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Mittal Patel
- Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Lin Eon Kuek
- Department of Biochemistry and Pharmacology, University of Melbourne, Melbourne, Victoria, Australia
| | - Yang Tran
- Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Johannes S Kern
- Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | | | | | | | | | | | - Graham A Mackay
- Department of Biochemistry and Pharmacology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jo A Douglass
- Royal Melbourne Hospital, Parkville, Victoria, Australia; Walter and Eliza Hall Institute, Melbourne, Victoria, Australia; Melbourne EpiCentre, University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
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Kaszuba A, Sławińska M, Żółkiewicz J, Sobjanek M, Nowicki RJ, Lange M. Mastocytosis and Skin Cancer: The Current State of Knowledge. Int J Mol Sci 2023; 24:9840. [PMID: 37372988 DOI: 10.3390/ijms24129840] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Mastocytosis is a heterogeneous group of diseases associated with excessive proliferation and accumulation of mast cells in different organs. Recent studies have demonstrated that patients suffering from mastocytosis face an increased risk of melanoma and non-melanoma skin cancer. The cause of this has not yet been clearly identified. In the literature, the potential influence of several factors has been suggested, including genetic background, the role of cytokines produced by mast cells, iatrogenic and hormonal factors. The article summarizes the current state of knowledge regarding the epidemiology, pathogenesis, diagnosis, and management of skin neoplasia in mastocytosis patients.
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Affiliation(s)
- Agnieszka Kaszuba
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Smoluchowskiego Street 17, 80-214 Gdańsk, Poland
| | - Martyna Sławińska
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Smoluchowskiego Street 17, 80-214 Gdańsk, Poland
| | - Jakub Żółkiewicz
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Smoluchowskiego Street 17, 80-214 Gdańsk, Poland
| | - Michał Sobjanek
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Smoluchowskiego Street 17, 80-214 Gdańsk, Poland
| | - Roman J Nowicki
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Smoluchowskiego Street 17, 80-214 Gdańsk, Poland
| | - Magdalena Lange
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Smoluchowskiego Street 17, 80-214 Gdańsk, Poland
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Arora N, Akin C, Kovalszki A. Mastocytosis in Pregnancy. Immunol Allergy Clin North Am 2023; 43:159-168. [PMID: 36411001 DOI: 10.1016/j.iac.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Mastocytosis is a rare neoplastic disorder of the mast cell lineage resulting in unregulated proliferation and activation of mast cells. Symptoms worsen in about one-third of pregnant patients. Treatment focuses on management of symptoms with antimediator therapy (H1 & H2 antihistamines, glucocorticoids, and epinephrine, if required). Medication selection requires care during labor and delivery. Although it is generally considered safe to use a medication patient tolerated before, some common medications may need to be avoided or used with caution (eg, codeine, morphine, nonsteroidal antiinflammatory drugs, vancomycin) if the patient does not have any history of exposure to them.
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Affiliation(s)
- Nonie Arora
- Department of Internal Medicine, Michigan Medicine, 3116 Taubman Center, SPC 53681500 E. Medical Center Drive, Ann Arbor, MI 48109-5368, USA
| | - Cem Akin
- Allergy and Immunology Division, University of Michigan, 24 Frank Lloyd Wright Drive, Suite H-2100, Ann Arbor, MI 48106, USA
| | - Anna Kovalszki
- Allergy and Immunology Division, University of Michigan, 24 Frank Lloyd Wright Drive, Suite H-2100, Ann Arbor, MI 48106, USA.
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Brodey A, Kounnis V, Hawkes L, Jones RL, McVeigh TP, Cojocaru E. KIT-Associated Familial GIST Syndrome: Response to Tyrosine Kinase Inhibitors and Implications for Risk Management. Oncologist 2022; 27:615-620. [PMID: 35791894 PMCID: PMC9355806 DOI: 10.1093/oncolo/oyac120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/23/2022] [Indexed: 01/09/2023] Open
Abstract
Sporadic gastrointestinal stromal tumors (GIST) are rare tumors, with a median age at diagnosis of 60 years. Familial GISTs are very rare and typically associated with earlier onset, with an average age at diagnosis of 48 years. To date, just over 50 familial cases associated with a germline variant KIT or PDGFRa genes have been published. Therefore, there are many challenges in managing these patients, including the timing of starting systemic treatment, considering that most patients have been asymptomatic for a long period before being diagnosed, as well as the choice of tyrosine kinase inhibitor and the plan for surveillance. It is uncertain if early diagnosis through screening of asymptomatic individuals improves overall survival. Screening could start from the age of 18 years but may be considered at earlier ages depending on the underlying genotype and family history. The long-term benefit of early diagnosis or palliative/prophylactic treatment with tyrosine kinase inhibitors is unknown as there are no data available. Long-term side effects of treatment with imatinib are rare but well documented and could be damaging in patients who have no or minimal disease. We present the case of a 53-year-old Caucasian patient who was diagnosed with multifocal GIST and subsequently found to be a carrier of a pathogenic germline KIT variant in exon 11. We discuss the implication of treatment and genetic testing in this case and in familial KIT associated GISTs.
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Affiliation(s)
- Alexandra Brodey
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Valentinos Kounnis
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Lara Hawkes
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Robin L Jones
- Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, UK.,Institute of Cancer Research, London, UK
| | - Terri P McVeigh
- Institute of Cancer Research, London, UK.,Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Elena Cojocaru
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK
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