{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T03:43:22Z","timestamp":1768275802537,"version":"3.49.0"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Systemic mastocytosis co-occurring with chronic myelomonocytic leukemia (SM-AHN) presents therapeutic challenges, especially in cases of cytopenia. We present a case of a 76-year-old woman with advanced SM-AHN and thrombocytopenia, who responded to reduced-dose avapritinib combined with dexamethasone. Initial treatment with midostaurin and azacitidine was discontinued due to hematological toxicity. Avapritinib (100\u00a0mg\/day) initiated but reduced to 50\u00a0mg\/day due to thrombocytopenia risk, with dexamethasone (20\u00a0mg) added for platelet support. Clinical improvement was observed within two weeks, with lymphadenopathy resolution, spleen and liver size reduction, platelet count normalization, and serum tryptase decrease. Avapritinib combined with dexamethasone offers a promising therapeutic strategy for SM-AHN, particularly in thrombocytopenic cases.<\/jats:p>","DOI":"10.1093\/omcr\/omaf240","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T13:09:09Z","timestamp":1764767349000},"source":"Crossref","is-referenced-by-count":1,"title":["Avapritinib and corticosteroids in advanced systemic mastocytosis with tumoral CMML and associated thrombocytopenia"],"prefix":"10.1093","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7937-9786","authenticated-orcid":false,"given":"Ouadii","family":"Abakarim","sequence":"first","affiliation":[{"name":"Cabinet d'Hematologie Agadir , Borj Alwahda, Amsernate, Agadir 80020 ,","place":["Morocco"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramzi","family":"Jeddi","sequence":"additional","affiliation":[{"name":"Oncohematology Department, Castres-Mazamet Hospital , Castres 81108 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Rossignol","sequence":"additional","affiliation":[{"name":"French Reference Center for Mastocytosis (CEREMAST), H\u00f4pital Necker, Assistance Publique-H\u00f4pitaux de Paris , Paris 75015 ,","place":["France"]},{"name":"Department of Adult Clinical Hematology, H\u00f4pital Necker, Assistance Publique-H\u00f4pitaux de Paris , 75015 Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Hermine","sequence":"additional","affiliation":[{"name":"French Reference Center for Mastocytosis (CEREMAST), H\u00f4pital Necker, Assistance Publique-H\u00f4pitaux de Paris , Paris 75015 ,","place":["France"]},{"name":"Department of Adult Clinical Hematology, H\u00f4pital Necker, Assistance Publique-H\u00f4pitaux de Paris , 75015 Paris 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Galway , Galway H91 YR71 ,","place":["Ireland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"2025122602494805800_ref1","doi-asserted-by":"publisher","first-page":"5727","DOI":"10.1182\/blood-2009-02-205237","article-title":"Systemic mastocytosis in 342 consecutive adults: survival studies and prognostic factors","volume":"113","author":"Lim","year":"2009","journal-title":"Blood."},{"key":"2025122602494805800_ref2","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1182\/blood.2019000932","article-title":"New developments in diagnosis, prognostication, and treatment of advanced systemic mastocytosis","volume":"135","author":"Reiter","year":"2020","journal-title":"Blood."},{"key":"2025122602494805800_ref3","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/s00428-022-03423-3","article-title":"The international consensus classification of mastocytosis and related 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analysis","volume":"40","author":"L\u00fcbke","year":"2022","journal-title":"J Clin Oncol"},{"key":"2025122602494805800_ref10","doi-asserted-by":"publisher","first-page":"2108","DOI":"10.1038\/s41375-022-01615-z","article-title":"Efficacy of avapritinib versus best available therapy in the treatment of advanced systemic mastocytosis","volume":"36","author":"Reiter","year":"2022","journal-title":"Leukemia."}],"container-title":["Oxford Medical Case 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