Clinical features and survival of patients with indolent systemic mastocytosis defined by the updated WHO classification

Jakub Trizuljak, Wolfgang R. Sperr, Lucie Nekvindová, Hanneke O. Elberink, Karoline V. Gleixner, Aleksandra Gorska, Magdalena Lange, Karin Hartmann, Anja Illerhaus, Massimiliano Bonifacio, Cecelia Perkins, Chiara Elena, Luca Malcovati, Anna B. Fortina, Khalid Shoumariyeh, Mohamad Jawhar, Roberta Zanotti, Patrizia Bonadonna, Francesca Caroppo, Alexander ZinkMassimo Triggiani, Roberta Parente, Nikolas von Bubnoff, Akif S. Yavuz, Hans Hägglund, Mattias Mattsson, Jens Panse, Nadja Jäkel, Alex Kilbertus, Olivier Hermine, Michel Arock, David Fuchs, Vito Sabato, Knut Brockow, Agnes Bretterklieber, Marek Niedoszytko, Björn van Anrooij, Andreas Reiter, Jason Gotlib, Hanneke C. Kluin-Nelemans, Jiri Mayer, Michael Doubek*, Peter Valent

*Corresponding author for this work
5 Citations (Scopus)


Background: In indolent systemic mastocytosis (ISM), several risk factors of disease progression have been identified. Previous studies, performed with limited patient numbers, have also shown that the clinical course in ISM is stable and comparable to that of cutaneous mastocytosis (CM). The aim of this project was to compare the prognosis of patients with ISM with that of patients with CM. Methods: We employed a dataset of 1993 patients from the registry of the European Competence Network on Mastocytosis (ECNM) to compare outcomes of ISM and CM. Results: We found that overall survival (OS) is worse in ISM compared to CM. Moreover, in patients with typical ISM, bone marrow mastocytosis (BMM), and smoldering SM (SSM), 4.1% of disease progressions have been observed (4.9% of progressions in typical ISM group, 1.7% in BMM, and 9.4% in SSM). Progressions to advanced SM were observed in 2.9% of these patients. In contrast, six patients with CM (1.7%) converted to ISM and no definitive progression to advanced SM was found. No significant differences in OS and event-free survival (EFS) were found when comparing ISM, BMM, and SSM. Higher risk of both progression and death was significantly associated with male gender, worse performance status, and organomegaly. Conclusion: Our data confirm the clinical impact of the WHO classification that separates ISM from CM and from other SM variants.

Original languageEnglish
JournalAllergy: European Journal of Allergy and Clinical Immunology
Issue number8
Pages (from-to)1923-1934
Number of pages12
Publication statusPublished - 01.08.2020


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