Treatment of Systemic Mastocytosis in Pregnancy
Systemic mastocytosis presenting during pregnancy requires a carefully balanced approach: controlling mast cell activation while limiting fetal exposure to medications with potential harm.
Clinical Scenario
This protocol addresses the management of systemic mastocytosis in a pregnant patient. The central challenge is alleviating symptoms driven by mast cell activation using medications acceptable in pregnancy, in order to minimise potential harm to the fetus.
Treatment Direction
Management focuses on symptom control with pregnancy-appropriate agents. For severe cases that do not respond to conventional therapy, a specific form of cytoreductive treatment may be considered — though a number of agents used outside of pregnancy are not appropriate in this setting.
The complete selection criteria, agent of choice, and full regimen are in the structured protocol below.
References
DOI: 10.6004/jnccn.2018.0088
Management of SM during pregnancy involves alleviation of symptoms related to mast cell activation with the use of acceptable medications to minimize potential harm to the fetus.
Cytoreductive therapy with interferon-alfa can be considered for pregnant women with severe symptoms that are refractory to conventional therapy. However, the use of cladribine, imatinib, and midostaurin is not recommended.
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