Treatment of Systemic Mastocytosis with Osteoporosis

Clinical Scenario

This protocol covers patients with indolent or smoldering systemic mastocytosis (ISM/SSM) who have concurrent osteoporosis. In this population, treatment goals are primarily directed toward anaphylaxis prevention, symptom control, and osteoporosis management.

First-Line Approach

First-line management targets bone loss through a combination of supplementation and a bone-modifying agent. The approach involves calcium and vitamin D supplementation alongside a bisphosphonate — with specific agent selection guided by individual patient factors and route of administration.

The full regimen — including agent options, dosing schedules, and alternatives — is detailed in the complete protocol.