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Retornaz F, Grino M, Vanhaudenhuyse A, Chiche L, Stavris C, Bennani M, Faymonville ME, Alitta A. Hypnotherapy in Treatment of Mastocytosis: A Prospective Study. Int J Clin Exp Hypn 2021; 69:468-482. [PMID: 34474650 DOI: 10.1080/00207144.2021.1965484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Mastocytosis is an orphan disease associated with many systemic symptoms, chronic handicap, and potentially marked social consequences despite improved therapies. In this study, the authors aimed to measure the effect of 2 hypnosis sessions on mastocytosis symptoms in a clinical setting. Questionnaires (pain, flushes, energy, digestive symptoms, quality of life, perceived symptom severity, and global impression of change) were completed pre- and posthypnosis intervention. Data from 20 patients were analyzed (mean age: 53.3 years, 75% female). Compared to baseline assessment, patients exhibited a significant improvement immediately after the first and second hypnosis sessions with regard to the number of days with abdominal pain, abdominal pain intensity and fatigue (p = .03 and p = .005; p = .05 and p = .02; p = .034, and p = .039, respectively). Perceived severity of symptoms was significantly improved throughout the study (p = .0075). Long-term improvement in global impression of change was observed in half the responders (8/16). Patients with mastocytosis had an improvement in disabling symptoms with the impact of hypnotic intervention persisting at 1 month. Several patients experienced long-term improvement.
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Affiliation(s)
- Frédérique Retornaz
- Unité de Soins et de Recherche en Médecine Interne et Maladies Infectieuses, Hôpital Européen, Marseille, France
| | - Michel Grino
- Département de Recherche Clinique, Centre Gérontologique Départemental, Marseille, France.,C2VN, Aix Marseille Univ., INSERM, INRAE, France
| | - Audrey Vanhaudenhuyse
- Département d'Algologie, CHU De Liège-B35, and Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Domaine Universitaire du Sart Tilman, Belgium
| | - Laurent Chiche
- Unité de Soins et de Recherche en Médecine Interne et Maladies Infectieuses, Hôpital Européen, Marseille, France
| | - Chloé Stavris
- Unité de Soins et de Recherche en Médecine Interne et Maladies Infectieuses, Hôpital Européen, Marseille, France
| | - Myriam Bennani
- Unité de Soins et de Recherche en Médecine Interne et Maladies Infectieuses, Hôpital Européen, Marseille, France
| | - Marie Elisabeth Faymonville
- Département d'Algologie, CHU De Liège-B35, and Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Domaine Universitaire du Sart Tilman, Belgium
| | - Anouk Alitta
- Unité de Soins et de Recherche en Médecine Interne et Maladies Infectieuses, Hôpital Européen, Marseille, France
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Barete S. Les mastocytoses. Ann Dermatol Venereol 2014; 141:698-714; quiz 697, 715. [DOI: 10.1016/j.annder.2014.08.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/21/2014] [Accepted: 08/29/2014] [Indexed: 01/05/2023]
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Sokol H, Georgin-Lavialle S, Grandpeix-Guyodo C, Canioni D, Barete S, Dubreuil P, Lortholary O, Beaugerie L, Hermine O. Gastrointestinal involvement and manifestations in systemic mastocytosis. Inflamm Bowel Dis 2010; 16:1247-53. [PMID: 20162539 DOI: 10.1002/ibd.21218] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Mastocytosis is a rare and heterogeneous disease characterized by various biological and clinical features with different prognosis and treatments. The disease is usually divided into 2 categories: a pure cutaneous and a systemic disease. Clinical features can be related to mast cells' mediators release or to pathological mast cells infiltration. The diagnosis of mastocytosis is based on clinical, biological, histological, and molecular international criteria. Among all manifestations of the disease, gastrointestinal (GI) symptoms are common and can significantly impair the quality of life. The aim of this article is to review the data regarding GI involvement in mastocytosis. Articles dealing with clinical, pathophysiological, and therapeutic aspects of mastocytosis GI tract involvement were searched for using PubMed. GI manifestations in mastocytosis are reviewed. Pathogenesis of GI symptoms in systemic mastocytosis and their treatment are critically discussed. The most frequent GI symptoms are abdominal pain, diarrhea, nausea, and vomiting. GI lesions may involve all the digestive tract, from the esophagus to the rectum. The histological diagnosis of GI involvement is difficult. The treatment of GI symptoms aims to prevent and limit mast cells degranulation and/or its consequences and more rarely to control tumoral mast cells infiltration. The high prevalence of GI symptoms in mastocytosis and their important functional impact deserves better characterization and treatment in order to improve patients' quality of life. Diagnosis of mastocytosis GI manifestations should be evoked in the case of unexplained severe GI disorders.
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Affiliation(s)
- Harry Sokol
- Department of Gastroenterology and Nutrition, Saint-Antoine Hospital, Université Paris VI, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris, Paris, France.
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Georgin-Lavialle S, Barete S, Suarez F, Lepelletier Y, Bodemer C, Dubreuil P, Lortholary O, Hermine O. Actualités sur la compréhension et le traitement des mastocytoses systémiques. Rev Med Interne 2009; 30:25-34. [DOI: 10.1016/j.revmed.2008.01.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Revised: 01/26/2008] [Accepted: 01/28/2008] [Indexed: 01/08/2023]
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Dewachter P, Mouton-Faivre C, Cazalaà JB, Carli P, Lortholary O, Hermine O. Mastocytoses et anesthésie. ACTA ACUST UNITED AC 2009; 28:61-73. [DOI: 10.1016/j.annfar.2008.09.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2008] [Accepted: 09/26/2008] [Indexed: 10/21/2022]
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Stankovic K, Sarrot-Reynauld F, Puget M, Massot C, Ninet J, Lorcerie B, Dupond JL, Salles G, Durieu I, Vital Durand D, Rousset H. Systemic mastocytosis: predictable factors of poor prognosis present at the onset of the disease. Eur J Intern Med 2005; 16:387-90. [PMID: 16198895 DOI: 10.1016/j.ejim.2005.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2004] [Revised: 11/22/2004] [Accepted: 02/03/2005] [Indexed: 10/25/2022]
Abstract
Systemic mastocytosis (SM) refers to a group of heterogeneous diseases that can be divided into indolent SM, for which prognosis is favorable, and malignant SM, which has a poor prognosis. While the diagnosis of SM is often a challenge since clinical and biological abnormalities are not specific, prognosis is even more difficult to predict. Thus, we aimed to highlight predictable factors in a cohort of 28 cases of SM. Among the 13 women and 15 men studied were 7 patients who had an aggressive form of SM that ultimately led to death in 3 of them. We found common characteristics among these seven patients. First, they were older when the first symptoms appeared and when the diagnosis was confirmed. Second, ascitis, lymphadenopathy, anemia, and thrombocytopenia were significantly more frequent, while cutaneous lesions and flush were less frequent. Moreover, general symptoms, gastrointestinal disorders, neutropenia, and coagulation abnormalities also seemed to characterize this group of patients. Understanding the factors that predict SM is essential in order to provide patients with the malignant form of the disease with specific treatments.
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Abstract
Systemic mastocytosis is characterized by abnormal mast cell proliferation in different organs. The 2001 consensus classification distinguishes in separate categories indolent systemic mastocytosis, systemic mastocytosis with concomitant blood disease, aggressive systemic mastocytosis and mast cell leukemia. Clinical manifestations are caused by tissue infiltration by proliferating mastocytes and by release of mediators. The principal organs affected are the skin, bones, digestive tract, liver, spleen and lymph nodes. Diagnosis of mastocytosis is based on appropriate stains (Giemsa, toluidine blue) and immunophenotype features (tryptase, CD117, also known as c-KIT and stem cell factor receptor). Serum tryptase levels reflect the total mast cell burden. Treatment must prevent release of mast cell mediators (histamine antagonists, cromolyn sodium, corticosteroids, or leukotriene-receptor inhibitors), limit bone involvement (bisphosphonates) and reduce the number of circulating mast cells (interferon, cladribine, or tyrosine kinase inhibitors). Enhanced understanding of the pathogenic mechanisms (mutation of c-kit and platelet-derived growth factor receptor alpha has led to the development of targeted treatments, including new inhibitors of tyrosine kinase and of nuclear factor Kappa B.
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Affiliation(s)
- O Fain
- Service de médecine interne, Hôpital Jean Verdier (AP-HP), Université Paris XIII, Bondy.
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Simon J, Lortholary O, Caillat-Vigneron N, Raphaël M, Martin A, Brière J, Barète S, Hermine O, Casassus P. Interest of interferon alpha in systemic mastocytosis. The French experience and review of the literature. ACTA ACUST UNITED AC 2004; 52:294-9. [PMID: 15217717 DOI: 10.1016/j.patbio.2004.04.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2004] [Accepted: 04/13/2004] [Indexed: 01/03/2023]
Abstract
Systemic mastocytosis (SM) are defined by an abnormal growth and accumulation of mast cells in bone marrow and/or other extracutaneous organs. There is currently no cure for this disease. Because of similarities and/or association of mastocytosis with myeloproliferative disorders, interferon alpha has been tested but with contradictory reported results. A first prospective multicenter phase II trial was then started in France. From 1994 to 1997, 20 adult patients with confirmed bone marrow involvement received interferon alpha-2b for at least 6 months, (from 1 million U per day up to 5 million U/m(2)/day). Thirteen patients who presented systemic and/or specific cutaneous manifestations, demonstrated objective responses: seven (35%) were partial, six (30%) minor but no complete response could be observed at the time of analysis. The bone marrow remained unchanged in 12/13. Thus, interferon should be offered to patients with severe systemic manifestations, who have not responded to symptomatic therapies, even in case of non-aggressive mastocytosis, with or without corticosteroids the first weeks. Long-term therapy should be offered to patients with initial positive response. To control more aggressive SM or mastocytosis associated with clonal hematologic non-mast cell lineage or leukaemia mast cell, other chemotherapeutic regimens should be proposed like Cladribine (2-chlorodeoxyadenosine, 2-CDA) or polychemotherapies including interferon as it is being tested in France in a new multicentric protocol, coordinated by the association AFIRMM, with interferon and oral cytarabine.
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Affiliation(s)
- J Simon
- Service de médecine Interne-néphrologie, Centre hospitalier Intercommunal de Poissy-Saint-Germain-en-Laye, 10, rue Champ Gaillard, 78300 Poissy, France.
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Arock M. [Mastocytosis: advances in molecular diagnosis and therapeutics]. ANNALES PHARMACEUTIQUES FRANÇAISES 2004; 62:233-43. [PMID: 15243341 DOI: 10.1016/s0003-4509(04)94307-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Systemic mastocytosis is a rare myeloproliferative-like disease, characterized by an abnormal proliferation of mast cells in various organs. Two types of clinical manifestations can be distinguished: those related to release of mast cell mediators release and those related to tumor proliferation involving different organs, these later defining systemic mastocytosis. Until recently, treatment was mainly symptomatic, without anti tumor effect. These last years, advances have been made in the understanding of the disease with the discovery of the presence, in a number of patients, of mutations of the c-kit oncogene, coding for the receptor of the major growth factor for mast cells. These mutations induce autophosphorylation of the c-kit receptor in the absence of its ligand, the Stem Cell Factor. Based on experiences acquired in the treatment of myeloproliferative disorders, evaluation of new therapeutics, such as cladribine or interferon-alpha, is in progress. Finally, it would be possible to design, in the very next future, new tyrosine kinase inhibitors targeting specifically the mutant forms of c-Kit found in patients suffering from systemic mastocytosis.
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Affiliation(s)
- M Arock
- Laboratoire d'hématologie cellulaire et moléculaire, Unité CNRS UMR 8147, Faculté de Pharmacie 4, avenue de l'Observatoire, F75270 Paris Cedex.
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Silvain C. [Towards molecular management of systemic mastocytosis]. GASTROENTEROLOGIE CLINIQUE ET BIOLOGIQUE 2004; 28:33-4. [PMID: 15041807 DOI: 10.1016/s0399-8320(04)94837-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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