Table 2

WHO diagnostic criteria (2008) for systemic mastocytosis

Criteria
Major 
    Multifocal, dense infiltrates of MC (≥ 15 MC in aggregates) in BM and/or other extracutaneous organ(s) 
Minor 
    (1) > 25% of MC in the infiltrate of biopsy sections are spindle-shaped or have atypical morphology or, of all MC in the BM aspirate smears, > 25% are immature or atypical 
    (2) Activating point mutation at codon 816 of c-KIT in BM, blood, or another extracutaneous organ 
    (3) MC in BM, blood, or extracutaneous organs express CD2 and/or CD25 in addition to normal MC markers 
    (4) Total serum tryptase persistently exceeds 20 ng/mL* 
Criteria
Major 
    Multifocal, dense infiltrates of MC (≥ 15 MC in aggregates) in BM and/or other extracutaneous organ(s) 
Minor 
    (1) > 25% of MC in the infiltrate of biopsy sections are spindle-shaped or have atypical morphology or, of all MC in the BM aspirate smears, > 25% are immature or atypical 
    (2) Activating point mutation at codon 816 of c-KIT in BM, blood, or another extracutaneous organ 
    (3) MC in BM, blood, or extracutaneous organs express CD2 and/or CD25 in addition to normal MC markers 
    (4) Total serum tryptase persistently exceeds 20 ng/mL* 

Diagnosis of systemic mastocytosis requires the presence of the major criterion and 1 minor criterion or at least 3 minor criteria.

MC indicates mast cell; and BM, bone marrow.

*

Serum tryptase is not valid as a criterion if there is an associated clonal myeloid disorder.

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