Treatment of Indolent or Smoldering Systemic Mastocytosis with Headache, Cognitive Impairment, or Depression

Patients with indolent systemic mastocytosis (ISM) or smoldering systemic mastocytosis (SSM) who experience headache, cognitive impairment, or depressed mood present a specific management situation. In this population, treatment goals are primarily directed toward symptom control and anaphylaxis prevention.

First-line management in this setting involves a combination of two classes of histamine receptor antagonists. The specific agents, sequencing, and individualised algorithm are set out in the full structured protocol.