A new study published in the European Journal of Hematology urges researchers to take a closer look at the bone marrow microenvironment when considering future treatment options for systemic mastocytosis (SM).
In SM, faulty mast cells build up in the bone marrow and other parts of the body, causing symptoms like fatigue, gastrointestinal issues and allergic reactions, which can be severe. Current treatments focus on targeting the mast cells directly, especially those carrying a common gene mutation called KIT D816V. While these treatments are effective for many people with SM, symptoms can still persist for some.
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According to the new research, this may be in part due to the bone marrow microenvironment, the complex network of cells, structures and signals that surrounds and supports mast cells.
In healthy individuals, the bone marrow microenvironment plays a pivotal role in blood cell formation and regulates immune responses. However, in people with SM, the bone marrow microenvironment undergoes certain changes that may create conditions that promote mast cell survival, support inflammation and contribute to continued symptoms, the researchers note. This can occur despite medication therapy to treat SM.
The study authors call for more research to better understand these changes in the bone marrow and consider ways to target it alongside traditional therapies for SM. This could eventually lead to more effective, personalized treatments and longer-lasting symptom control.
“Overall, if we shift the tumor-centric view to a holistic approach that considers the bone marrow niche as a key to the disease, we can pave the way for innovative and personalized therapeutic strategies,” they concluded. “Our understanding of the bone marrow microenvironment will not only improve patient outcomes but also drive SM research into a new era of precision medicine.”
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