Depression in patients with mastocytosis: prevalence, features and effects of masitinib therapy.
Depression in patients with mastocytosis is often reported but its prevalence and characteristics are not precisely described. In addition, the impact of therapies targeting mast cells proliferation, differentiation and degranulation on psychic symptoms of depression have never been investigated. Our objective was to determine the prevalence and to describe features of depression in a large cohort of mastocytosis patients (n = 288) and to investigate the therapeutic impact of the protein kinase inhibitor masitinib in depression symptoms. The description of depression was based on the analysis of a database with Hamilton scores using Principal Component Analysis (PCA). Efficacy of masitinib therapy was evaluated using non parametric Wilcoxon test for paired data within a three months period (n = 35). Our results show that patients with indolent mastocytosis present an elevated prevalence of depression (64%). Depression was moderate in 56% but severe in 8% of cases. Core symptoms (such as psychic anxiety, depressed mood, work and interests) characterized depression in mastocytosis patients. Masitinib therapy was associated with significant improvement (67% of the cases) of overall depression, with 75% of recovery cases. Global Quality of Life slightly improved after masitinib therapy and did not predicted depression improvement. In conclusion, depression is very frequent in mastocytosis patients and masitinib therapy is associated with the reduction its psychic experiences. We conclude that depression in mastocytosis may originate from processes related to mast cells activation. Masitinib could therefore be a useful treatment for mastocytosis patients with depression and anxiety symptoms.
Université Paris Descartes, Sorbonne, Paris Cité, Service d'hématologie, Centre de référence des mastocytoses, Hôpital Necker Enfants malades, Paris, France.
Daniela Silva
DS
Moura
Serge
S
Sultan
Sophie
S
Georgin-Lavialle
Nathalie
N
Pillet
François
F
Montestruc
Paul
P
Gineste
Stéphane
S
Barete
Gandhi
G
Damaj
Alain
A
Moussy
Olivier
O
Lortholary
Olivier
O
Hermine
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001549:Benzamides; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008415:Mastocytosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology*; D008875:Middle Aged; D010880:Piperidines; D011725:Pyridines; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult
D000970:Antineoplastic Agents; D001549:Benzamides; D010880:Piperidines; D011725:Pyridines; D013844:Thiazoles; C526575:masitinib