Abstract
In May 2003, a 65-year-old white male presented with weight loss, night sweats, pruritus, diarrhoea, and joint pain. Radiographic studies showed hepatosplenomegaly, abdominal lymphadenopathy and both osteoblastic and osteolytic bone lesions. Bone marrow biopsy showed extensive mast cell infiltration and effacement of marrow structure with reduction of fat cells and marked osteomyelosclerosis (top, Giemsa stain). We administered six courses of therapy with cladribine (0AE1 mg/kg body weight for 5 d, monthly), which reduced mast cell infiltration and restored marrow structure to a nearnormal state (bottom, Giemsa stain). Mediator-related symptoms (night sweats, pruritus, arthralgia, diarrhoea) disappeared completely. Two years after the diagnosis of mast cell leukaemia the patient has a 90–100% Karnofsky performance status.
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