Mastocytosis: What is It and How Is It Treated?

November 11, 2019

Mastocytosis is a rare type of mast cell disorder characterized by the abnormal accumulation of mast cells in various organ systems such as the skin, liver, spleen, intestine, or bone marrow. It is one of two major types of mast cell disorders; the other major, more common type is mast cell activation syndrome.

Mast cell leukemia is characterized by a high number of mast cells in the bone marrow.
Mast cell leukemia is characterized by a high number of mast cells in the bone marrow.

To keep us healthy, mast cells protect our body from foreign threats, such as infections, and help repair its tissues once the threat is gone. As part of their role in the immune system, they create histamine — neurotransmitters that react to those threats and allergens, such as bee stings. Histamine is also released in response to allergens, causing reaction symptoms such as inflammation and even anaphylaxis, a severe, potentially life-threatening kind of reaction.

What triggers mastocytosis?

Mastocytosis is caused by a genetic mutation in which the body accumulates too many mast cells — white blood cells that are part of the immune system and help fight infections.

Systemic mastocytosis, which is also known as systemic mast cell disease, is mostly present in adults. It occurs when mast cells have infiltrated the body’s organs, such as the gastrointestinal tract, bone marrow, liver, spleen, and lymph nodes.

Signs and symptoms

In many cases, urticaria pigmentosa — the appearance of dark pigments on the skin — is the first visible symptom. Recurrent anaphlylactic reactions is another common symptom. There are a myriad of other symptoms usually associated with the area of the body where the mast cells have infiltrated, including:

  • Recurrent anaphylactic reactions (to insect stings, general anesthetics, intravenous contrast media, and other drugs and foods)
  • Pruritus and flushing
  • Symptoms and signs of gastroesophageal reflux disease (GERD)
  • Abdominal pain is the most common gastrointestinal symptom, followed, by diarrhea, nausea, and vomiting
  • Anemia and coagulopathy

Systemic mastocytosis is diagnosed through a bone marrow aspiration and biopsy and may involve care by a hematologist/oncologist.

Learn More:

Systemic mastocytosis has three forms: indolent systemic mastocytosis (the most common) and smoldering mastocytosis, which progress slowly and often do not require therapy; and aggressive systemic mastoyctosis, which is fast-growing. Some forms of systemic mastocytosis may also be associated with a second blood disorder, such as myeloproliferative or myelodysplastic disorders. The rarest form of systemic mastocytosis is mast cell leukemia, characterized by a high number of mast cells in the bone marrow. These aggressive forms of systemic mastocytosis or mast cell leukemia are generally treated with chemotherapy.

Learn more about treatment for blood disorders from the Hematologic Oncology Treatment Center at Dana-Farber/Brigham and Women’s Cancer Center.