Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Delayed graft-versus-mast-cell effect on systemic mastocytosis with associated clonal haematological non-mast cell lineage disease after allogeneic transplantation

Bone Marrow Transplantation volume 48, pages 732–733 (2013)Cite this article

Subjects

Mastocytosis is a rare heterogeneous disease with an incidence of five cases per million. In adults, it usually occurs in the form of systemic mastocytosis (SM). According to the World Health Organisation, 30% of patients with SM develop an associated clonal haematological non-mast cell lineage disease (SM-AHNMD) that determines overall prognosis, while the prognostic relevance of SM in these cases remains unclear. Unfortunately, successful treatment of the AHNMD hardly ever seems to include a lasting remission of SM. Thus, there is an ongoing discussion about the existence of a graft-versus-mast-cell (GvMC) effect after allo-SCT. Even concerning the special entity of SM-AHNMD there are controversial opinions.1, 2 In cases where a putative GvMC effect is described, long-lasting complete remissions are rarely seen.1, 3

Therefore, we report the rare case of one patient with SM and AML who achieved a CR of AML immediately after SCT. Interestingly, an at least very good stabilizing partial or maybe even CR of SM occurred with a delay of 3 years. Remission criteria are clearly defined for AML, but not for SM—especially not for SM-AHNMD. We used the criteria established for aggressive SM by Valent et al.4 as most applicable.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Nakamura R, Chakrabarti S, Akin C, Robyn J, Bahceci E, Greene A et al. A pilot study of nonmyeloablative allogeneic hematopoietic stem cell transplant for advanced systemic mastocytosis. Bone Marrow Transplant 2006; 37: 353–358.

    Article  CAS  Google Scholar 

  2. Rønnov-Jessen D, Løvgreen Nielsen P, Horn T . Persistence of systemic mastocytosis after allogeneic bone marrow transplantation in spite of complete remission of the associated myelodysplastic syndrome. Bone Marrow Transplant 1991; 8: 413–415.

    PubMed  Google Scholar 

  3. Pagano L, Valentini CG, Caira M, Rondoni M, Van Lint MT, Candoni A et al. Advanced mast cell disease: an Italian hematological multicenter experience. Int J Hematol 2008; 88: 483–488.

    Article  Google Scholar 

  4. Valent P, Akin C, Sperr WR, Escribano L, Arock M, Horny HP et al. Aggressive systemic mastocytosis and related mast cell disorders: current treatment in options and proposed response criteria. Leuk Res 2003; 27: 635–641 (review).

    Article  CAS  Google Scholar 

  5. Chong G, Byrnes G, Szer J, Grigg A . Extramedullary relapse after allogeneic bone marrow transplantation for haematological malignancy. Bone Marrow Transplant 2000; 26: 1011–1015 (review).

    Article  CAS  Google Scholar 

  6. Ludolph-Hauser D, Ruëff F, Sommerhoff CP, Przybilla B . Tryptase a marker for the activation and localization of mast cells. Hautarzt 1999; 50: 556–561 (review; German).

    Article  CAS  Google Scholar 

  7. Zettinig G, Becherer A, Szabo M, Uffmann M, Dudczak R, Valent P et al. FDG positron emission tomography in patients with systemic mastocytosis. AJR Am J Roentgenol 2002; 179: 1235–1237.

    Article  Google Scholar 

  8. LeBlanc AK, Jakoby BW, Townsend DW, Daniel GB . 18FDG-PET imaging in canine lymphoma and cutaneous mast cell tumor. Vet Radiol Ultrasound 2009; 50: 215–223.

    Article  Google Scholar 

  9. Kurosawa M, Amano H, Kanbe N, Igarashi Y, Nagata H, Yamashita T et al. Response to cyclosporin and low-dose methylprednisolone in aggressive systemic mastocytosis. J Allergy Clin Immunol 1999; 1003 (Part 2): 412–420.

    Article  Google Scholar 

  10. Worobec AS . Treatment of systemic mast cell disorders. Hematol Oncol Clin North Am 2000; 14: 659–687 (vii; review).

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank all physicians involved in the patient’s therapy for providing information about the course of disease.

Author information

Authors and Affiliations

  1. Department of Bone Marrow Transplantation, University Hospital of Essen, Essen, Germany

    T Gromke, A H Elmaagacli, M Ditschkowski, Y Hegerfeldt, M Koldehoff, M Hlinka, H Ottinger, R Trenschel & D W Beelen

Authors
  1. T Gromke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A H Elmaagacli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M Ditschkowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y Hegerfeldt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M Koldehoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M Hlinka
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. H Ottinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. R Trenschel
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. D W Beelen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T Gromke.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gromke, T., Elmaagacli, A., Ditschkowski, M. et al. Delayed graft-versus-mast-cell effect on systemic mastocytosis with associated clonal haematological non-mast cell lineage disease after allogeneic transplantation. Bone Marrow Transplant 48, 732–733 (2013). https://doi.org/10.1038/bmt.2012.198

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2012.198

This article is cited by

Search

Advanced search

Quick links