Survey of aspirin administration in systemic mastocytosis.

BACKGROUND: Previous recommended doses for aspirin use in systemic mastocytosis have been 3.9-5.2g/d. Here, the aspirin doses and biochemical responses of patients with systemic mastocytosis given aspirin to decrease prostaglandin D(2) levels and prevent symptoms were reviewed.

METHODS: Twenty patients with systemic mastocytosis who had been given aspirin were identified, and their clinical and laboratory records were reviewed including changes in the excretion of the prostaglandin D(2) metabolite 11beta-prostaglandin F(2alpha) in response to aspirin.

RESULTS: Two of 20 patients developed either a delayed reaction or flushing during outpatient updosing with aspirin. In 20 of 20 patients with elevated baseline urinary excretion of 11beta-prostaglandin F(2alpha), aspirin therapy caused a reduction to normal levels of excretion. Doses of aspirin required ranged from 81mg twice daily to 500mg twice daily.

CONCLUSIONS: Control of elevated prostaglandin D(2) levels in systemic mastocytosis can be achieved with lower doses of aspirin than previously reported as necessary in this disorder.