Survey of aspirin administration in systemic mastocytosis

Background: Previous recommended doses for aspirin use in systemic mastocytosis have been 3.9-5.2 g/d. Here, the aspirin doses and biochemical responses of patients with systemic mastocytosis given aspirin to decrease prostaglandin D₂ 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 D₂ metabolite 11β-prostaglandin F_2α 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 11β-prostaglandin F_2α, aspirin therapy caused a reduction to normal levels of excretion. Doses of aspirin required ranged from 81 mg twice daily to 500 mg twice daily. Conclusions: Control of elevated prostaglandin D₂ levels in systemic mastocytosis can be achieved with lower doses of aspirin than previously reported as necessary in this disorder.