Mast cell leukemia overview

# Overview
Mast cell leukemia was first described in 1906 by G. Joachim. Mast cell leukemia may be classified into two categories based on prognosis. Based on the duration of symptoms, mast cell leukemia may be classified into either acute or chronic. Genes involved in the pathogenesis of mast cell leukemia include KIT D816V and non-KIT D816V. There are no characteristic findings of mast cell leukemia on gross pathology. On microscopic histopathological analysis, multifocal sheets and clusters of mast cells in bone marrow sections are findings of mast cell leukemia. Common causes of mast cell leukemia include genetic mutations. Common genetic mutations involved in the development of mast cell leukemia can be found here. Mast cell leukemia must be differentiated from other diseases such as systemic mastocytosis, myelomastocytic leukemia, hairy cell leukemia, reactive mast cell hyperplasia, and peripheral T-cell leukemia. The incidence of mast cell leukemia increases with age; the median age at diagnosis is 52 years. Mast cell leukemia commonly affects individuals between 5 to 76 years of age. Females are more commonly affected with mast cell leukemia than males. The female to male ratio is 1.5 to 1. Mast cell leukemia usually affects individuals of the Caucasian race. Risk factor for mast cell leukemia is systemic mastocytosis, a premalignant condition. Factors involved in malignant transformation of systemic mastocytosis into mast cell leukemia include advanced age, history of weight loss, anemia, thrombocytopenia, hypoalbuminemia, and an excess of bone marrow blasts. According to the United States Preventive Services Task Force, there is insufficient evidence to recommend routine screening for mast cell leukemia. If left untreated,patients with mast cell leukemia may progress to develop weight loss, ascites, and bone abnormalities. Common complications of mast cell leukemia include hepatosplenomegaly, lymphadenopathy, and osteoporosis. Prognosis is generally poor, and the median survival time is less than six months. Symptoms of mast cell leukemia include fever, weight loss, weakness, flushes, and pruritis. Common physical examination findings of mast cell leukemia include hepatosplenomegaly, lymphadenopathy, bone abnormalities, and ascites.Laboratory findings consistent with the diagnosis of mast cell leukemia include abnormal complete blood count, biochemistry, and immunohistochemistry. The mainstay of therapy for symptomatic mast cell leukemia patients is immunochemotherapy.

# Historical Perspective
Mast cell leukemia was first described in 1906 by G. Joachim.

# Classification
Mast cell leukemia may be classified into two categories based on prognosis. Based on the duration of symptoms, mast cell leukemia may be classified into either acute or chronic.

# Pathophysiology
Genes involved in the pathogenesis of mast cell leukemia include KIT D816V and non-KIT D816V. There are no characteristic findings of mast cell leukemia on gross pathology. On microscopic histopathological analysis, multifocal sheets and clusters of mast cells in bone marrow sections are findings of mast cell leukemia.

# Causes
Common causes of mast cell leukemia include genetic mutations. Common genetic mutations involved in the development of mast cell leukemia can be found here.

# Differentiating Mast cell leukemia from other Diseases
Mast cell leukemia must be differentiated from other diseases such as systemic mastocytosis, myelomastocytic leukemia, hairy cell leukemia, reactive mast cell hyperplasia, and peripheral T-cell leukemia.

# Epidemiology and Demographics
The incidence of mast cell leukemia increases with age; the median age at diagnosis is 52 years. Mast cell leukemia commonly affects individuals between 5 to 76 years of age.  Females are more commonly affected with mast cell leukemia than males. The female to male ratio is 1.50 to 1. Mast cell leukemia usually affects individuals of the Caucasian race.

# Risk Factors
Risk factor for mast cell leukemia is systemic mastocytosis, a premalignant condition. Factors involved in malignant transformation of systemic mastocytosis into mast cell leukemia include advanced age, history of weight loss, anemia, thrombocytopenia, hypoalbuminemia, and an excess of bone marrow blasts.

# Screening
According to the United States Preventive Services Task Force, there is insufficient evidence to recommend routine screening for mast cell leukemia.

# Natural History, Complications and Prognosis
If left untreated, patients with mast cell leukemia may progress to develop weight loss, ascites, and bone abnormalities. Common complications of mast cell leukemia include hepatosplenomegaly, lymphadenopathy, and osteoporosis. Prognosis is generally poor, and the median survival time is less than six months.

# Diagnosis

## History and symptoms
Symptoms of mast cell leukemia include fever, weight loss, weakness, flushes, and pruritis.

## Physical Examination
Common physical examination findings of mast cell leukemia include hepatosplenomegaly, lymphadenopathy, bone abnormalities, and ascites.

## Laboratory Findings
Larboratoy findings consistent with the diagnosis of mast cell leukemia include abnormal complete blood count, biochemistry, and immunohistochemistry.

## CT
CT scan may be helpful in the diagnosis of mast cell leukemia. Findings on CT scan of the abdomen suggestive of mast cell leukemia include ascites, hepatosplenomegaly, and upper abdominal lymphadenopathy.

## MRI
There are no MRI findings associated with mast cell leukemia.

## Other Imaging Findings
There are no other imaging findings associated with mast cell leukemia.

## Other Diagnostic Studies
Other diagnostic studies for mast cell leukemia include flow cytometry.

# Treatment

## Medical therapy
The mainstay of therapy for symptomatic mast cell leukemia patients is immunochemotherapy.

## Surgery
The predominant therapy for mast cell leukemia is immunochemotherapy. Surgical management, such as splenedctomy or bone marrow transplantation may be required in certain cases.

## Prevention
There are no primary or secondary preventive measures available for mast cell leukemia.