New insights into thallium(I) behaviors at birnessite surfaces: Effects of an organic buffer and goethite.

Understanding the environmental behavior of thallium (Tl) is crucial due to its high toxicity and increasing anthropogenic presence. This study investigated the adsorption and redox behaviors of Tl(I) with acid birnessite (AcBi) in the presence of 1,4-piperazine-diethanesulfonic acid (PIPES) and goethite under diffusion-limited conditions using Donnan reactors in aerobic and anaerobic environments. Our findings indicate that Tl(I) preferentially adsorbs onto AcBi, with capacities 20 to 100 times higher than onto goethite, even when AcBi is partial reduced by PIPES. No net Tl(I) oxidation occurred in the Donnan reactors, likely due to complex electron transfer processes between Tl(I), birnessite, and PIPES. Any Tl(III) generated from Tl(I) oxidation by birnessite was rapidly reduced back to Tl(I) by PIPES. This was confirmed in batch experiments where reduced Tl(III) on birnessite surfaces and in Tl(III) salts. These findings highlight the need to assess the impact of Good's buffers on redox reactions involving manganese oxides and Tl, while also providing insights into the competitive retention of Tl on manganese and iron (hydr)oxides, with implications for Tl mobility and bioavailability in natural environments.

Immune effector cell-associated enterocolitis following chimeric antigen receptor T-cell therapy in multiple myeloma.

We report 14 cases of immune effector cell (IEC)-associated enterocolitis following chimeric antigen receptor T-cell (CAR-T) therapy in multiple myeloma, with a 1.2% incidence overall (0.2% for idecabtagene vicleucel and 2.2% for ciltacabtagene autoleucel). Patients developed acute-onset symptoms (typically non-bloody Grade 3+ diarrhea) with negative infectious workup beginning a median of 92.5 days (range: 22-210 days) after CAR-T therapy and a median of 85 days after cytokine release syndrome resolution. Gut biopsies uniformly demonstrated inflammation, including intra-epithelial lymphocytosis and villous blunting. In one case where CAR-specific immunofluorescence stains were available, CAR T-cell presence was confirmed within the lamina propria. Systemic corticosteroids were initiated in 10 patients (71%) a median of 25.5 days following symptom onset, with symptom improvement in 40%. Subsequent infliximab or vedolizumab led to improvement in 50% and 33% of corticosteroid-refractory patients, respectively. Five patients (36%) have died from bowel perforation or treatment-emergent sepsis. In conclusion, IEC-associated enterocolitis is a distinct but rare complication of CAR-T therapy typically beginning 1-3 months after infusion. Thorough diagnostic workup is essential, including evaluation for potential T-cell malignancies. The early use of infliximab or vedolizumab may potentially hasten symptom resolution and lower reliance on high-dose corticosteroids during the post-CAR-T period.

Hypoxia exacerbate the marine ecological risk of arsenic: By stimulating its migration and release at the sediment-water interface.

Hypoxia severally increased the release and bioavailability of sedimentary arsenic (As) in marine systems. However, the specific details regarding As migration and associated risks during exacerbated deoxygenation remain unclear. In this study, simulation experiments were conducted at four different dissolved oxygen (DO) levels to investigate the effects of exacerbated hypoxia on As mobility across the sediment-water interface (SWI). Hypoxia induced a rapid release of both As(V) and As(III), with a higher release rate for As(III) compared to As(V) across all experimental groups. The amount and rate of dissolved total As (dTAs) released across the SWI was proportional to the reduction in DO over the incubation time. The labile As in the solid phase was predominantly in the form of As(V) across all experimental groups. However, As(V) and As(III) were be dominant in surface and deep porewaters, respectively, accompanied by a decrease in the solid As in the reducible fraction and a significant increase in the abundance of the As(V)-reducing functional gene arrA with depth in the low DO groups. This suggested that hypoxia enhanced As exchange between surface sediment and overlying water by promoting the reductive dissolution of As(V)-bearing Fe/Mn oxides and exacerbated the partitioning of As from deep sediments to porewater by preferentially driving As(V) reduction. Although the diffusion of As to the overlying water was paralleled by dissolved Fe, there was a decoupling between them due to the involvement of As(V)-reducing bacteria and desorption of Mn oxides. After the completion of the hypoxia incubation, dTAs concentrations in the overlying water exceeded levels in clean coastal waters by ∼6-fold, reaching reported concentrations that affect the detoxification mechanisms of microalgae. Based on the estimation, about 34 t of As was released into the overlying water during the hypoxic period in the Changjiang Estuary, accounting for up to 17.3 % of the surface sediment As capacity.

Antibiotic resistance genes (ARGs) and their eco-environmental response in the Bohai Sea sediments.

Antibiotic resistance genes (ARGs) are an important class of pollutants in the environment. This study investigated the characteristics and ecological effects of ARGs in the Bohai Sea sediments. The results showed that ARGs are widely distributed, and exhibit significant spatial and subtype variations, with absolute abundance following the decreasing order of Liaodong Bay, Laizhou Bay, Bohai Bay, and Bohai Strait. Tetracycline ARGs dominated, comprising 50 % to 62 % of all ARGs, with tetM having the highest abundance at 1.43 × 107 copies/g. Symbiotic network analysis revealed that the phyla Deinococcota, Dadabacteria were serve as the primary likely host of ARGs. The ARGs have a wide range of potential hosts, and bacteria often carry multiple ARGs, enhancing the mobility and ecological niche adaptation of ARGs. This study will provide an important reference for assessing ARGs pollution in semi-enclosed seas.

Implicit Flow Cytometric Diagnosis of Classic Hodgkin Lymphoma Using CD3+CD4+CD26- T-Cells.

BACKGROUND: Flow cytometry is not routinely performed in clinical laboratories for the diagnosis of classic Hodgkin lymphoma (CHL). METHODS: Fourteen cases of CHL and 132 cases of the control group were studied by 10-color flow cytometry, with markers including CD3, CD4, CD7, CD8, and CD26, as well as calculated parameters such as the CD4:CD8 ratio, percent CD3+CD4+CD26- T-cells of CD3+CD4+ T-cells, percent CD3+CD4+CD26- T-cells of total events, CD7 coefficient of variation among CD3+CD4+CD26- T-cells, and CD7 median fluorescence intensity of CD3+CD4+CD26- T-cells relative to CD3+CD8+ T-cells. RESULTS: CHL cases showed a median percent CD3+CD4+CD26- of CD3+CD4+ T-cells of 72.3% with range from 41.1% to 94.4%, median percent CD3+CD4+CD26- T-cells of total events of 17.4% with range from 4.6% to 52.5%, CD7 coefficient of variation among CD3+CD4+CD26- T-cells less than 100%, and CD7 median fluorescence intensity of CD3+CD4+CD26- T-cells relative to CD3+CD8+ T-cells of 1.7 with range from 0.4 to 3.5. In the control group, every entity showed some degree of overlap with CHL in terms of these parameters. A "Hodgkin score" was thus constructed to enhance separation of CHL from other entities. A threshold Hodgkin score of 15.35 achieved a sensitivity of 78.6% and specificity of 96.2% in the diagnosis of CHL. Incorporating the Hodgkin score into a simple algorithm raises the specificity to 100%. CONCLUSION: In this study, we used flow cytometry to demonstrate increased CD3+CD4+CD26- T-cells in CHL, and derived a Hodgkin score for the diagnosis of CHL.

Achieving Tunable Monomeric TADF and Aggregated RTP via Molecular Stacking.

Organic emitters with both thermally activated delayed fluorescence (TADF) and room-temperature phosphorescence (RTP) have attracted widespread interest for their intriguing luminescent properties. Herein, a series of triphenylamine-substituted isoquinoline derivatives possessing monomeric TADF and aggregated RTP properties are reported. As the molecules exhibited various forms of π-π and charge transfer (CT) stacking with different intensities, inter/intramolecular CT can be meticulously modulated to achieve tunable TADF-RTP. Aggregated phosphorescence originates from intermolecular CT initiated by CT dimers, whereas monomeric TADF is facilitated by intramolecular CT enhanced by π-π dimers. Leveraging the properties of these molecules, luminescent materials with tunable TADF-RTP properties in multistates are obtained by molecular substitution position alignment, dealing with different solvents, grinding, adjusting concentration, changing polymer matrix, photoactivation, and heat treatment. This work is critical for a deeper understanding of construction and regulation of the TADF-RTP dual-channel emission, enabling the development of advanced optoelectronic devices with tailored emission properties.

Clinicopathologic features and outcomes of acute leukemia harboring PICALM::MLLT10 fusion.

The PICALM::MLLT10 fusion is a rare but recurrent cytogenetic abnormality in acute leukemia, with limited clinicopathologic and outcome data available. Herein, we analyzed 156 acute leukemia patients with PICALM::MLLT10 fusion, including 12 patients from our institutions and 144 patients from the literature. The PICALM::MLLT10 fusion preferentially manifested in pediatric and young adult patients, with a median age of 24 years. T-lymphoblastic leukemia/lymphoma (T-ALL) constituted 65% of cases, acute myeloid leukemia (AML) 27%, and acute leukemia of ambiguous lineage (ALAL) 8%. About half of T-ALL were classified as an early T-precursor (ETP)-ALL. In our institutions' cohort, mediastinum was the most common extramedullary site of involvement. Eight of 12 patients were diagnosed with T-ALL exhibiting a pro-/pre-T stage phenotype (CD4/CD8-double negative, CD7-positive), and frequent CD79a expression. NGS revealed pathogenic mutations in 5 of 6 tested cases, including NOTCH1, and genes in RAS and JAK-STAT pathways and epigenetic modifiers. Of 138 cases with follow-up, pediatric patients (<18 years) had 5-year overall survival (OS) of 71%, significantly better than adults at 33%. The 5-year OS for AML patients was 25%, notably shorter than T-ALL patients at 54%; this distinction was observed in both pediatric and adult populations. Furthermore, adult but not pediatric ETP-ALL patients demonstrated inferior survival compared to non-ETP-ALL patients. Neither karyotype complexity nor transplant status had a discernible impact on OS. In conclusion, PICALM::MLLT10 fusion is most commonly seen in T-ALL patients, particularly those with an ETP phenotype. AML and adult ETP-ALL patients had adverse prognosis. PICALM::MLTT10 fusion testing should be considered in T-ALL, AML, and ALAL patients.

Acidification state and interannual variability in marginal sea: A case study of the Bohai and the Yellow Seas surface waters in April 2023.

The acidification of the marginal seawater was a more intricate process than the ocean. Although some studies have been done on seasonal acidification in the bottom water of Chinese marginal seas, research on surface water acidification has still been insufficient. We analyzed the acidification properties and controlling factors in the Bohai Sea (BS) and Yellow Sea (YS) surface water during April 2023. The observation showed that the average surface water pH of the BS, North Yellow Sea (NYS), and South Yellow Sea (SYS) were 8.09 ± 0.06, 8.13 ± 0.05, and 8.15 ± 0.05. Phytoplankton significantly impacted pH and Ωarag, while riverine inputs and biological activity played a vital role in controlling DIC and TA. The Yellow River significantly impacted the BS. The North Yellow Sea Cold Water Mass had a limited impact on acidification, while the South Yellow Sea Cold Water Mass significantly affected the SYS. Regarding seasonal fluctuations, Ωarag was significantly higher in summer than in other seasons. DIC and TA showed different patterns in both the BS and YS, with a minimal fluctuation in pH. Over the last two decades, the pH in the BS showed a slight annual decline, and the rate of change was (-1.45 ± 2.19) × 10-5 yr-1. In contrast, the NYS and SYS have slightly risen, with rates of change of (2.39 ± 1.24) × 10-5 and (1.23 ± 0.76) × 10-5 yr-1. We believed that surface water acidification in the BS and YS did not follow the expected trend of significant acidification observed in open oceanic regions. Instead, the acidification process in these marginal seas was dominated by local factors such as riverine inputs, biological activity, and cold water masses, resulting in minimal pH changes over the last two decades.

Different fates of particulate matters driven by marine hypoxia: A case study of oxygen minimum zone in the Western Pacific.

The oxygen minimum zone (OMZ) is an important representative of marine hypoxia in the open ocean, and it is developing rapidly under the context of global warming. However, the research on OMZ in the Western Pacific is still deficient. This study focused on its basic characteristics and impact on the degradation of particulate matters in the M4 seamount of Western Pacific. The results showed that the OMZ is located at 290-1100 m, just below the high-salinity area and thermocline. The M4 seamount has a weak impact on the OMZ, and only the bottom waters contacting with the seamount have a weak decrease in dissolved oxygen (DO). With the increase of water depth, particulate nitrogen and phosphorus decrease first above and in the OMZ and then increase below the OMZ, while particulate organic carbon (POC) gradually decreases. The low-DO environment in the OMZ is not conducive to the degradation of particulate matters, which promotes the transport of particulate matters to the deep sea, and most particulate matters have the lowest degradation rate here. The waters above the OMZ have the fastest change rate of particulate matters, in which particulate organic phosphorus (POP) and particulate inorganic phosphorus (PIP) are preferentially degraded, and the degradation rate of them is significantly higher than particulate organic nitrogen (PON) and particulate inorganic nitrogen (PIN). The particulate nitrogen and phosphorus in the waters below the OMZ continue to increase, while PON/total particulate nitrogen (TPN) and POP/total particulate phosphorus (TPP) increase significantly, and the increase rate of PIN and PIP is far lower than PON and POP, indicating that the increase of organic matters in particulate matters is more significant. It is speculated that this phenomenon might be related to the input of Antarctic Bottom Water or the in-situ production by microorganisms. This study revealed the relationship between OMZ and different particulate matters, which may provide a valuable pathway for the biogeochemical effects of OMZ in the Western Pacific.

Organic carbon in wet deposition of an urbanized coastal bay, North China: Flux, sources and biogeochemical implications.

The process of atmospheric organic carbon (OC) entering the ocean through wet deposition plays a crucial role in the global carbon cycle. To gain insights into the biogeochemical dynamics of OC at the land-sea margin, we conducted an extensive four-year investigation on precipitation OC in Jiaozhou Bay (JZB). The results showed that the volume-weighted mean concentration of particulate OC (POC) and dissolved OC (DOC) in precipitation were 0.38 and 2.06 mg C L-1 with an average wet deposition flux of OC for 2666.5 mg C m-2 yr-1. The source of POC in precipitation is predominantly by the C3 plant emission and burning and fossil fuel combustion. Wet deposition contributed 986.6 t yr-1 of OC of which 506.3 t yr-1 of bioavailable DOC, which could have significant implications for carbon cycle in the JZB. This study could enhance the understanding of the marine atmospheric OC in coastal areas.

Tailoring raloxifene into single-component molecular crystals possessing multilevel stimuli-responsive room-temperature phosphorescence.

Simultaneously achieving room-temperature phosphorescence (RTP) and multiple-stimuli responsiveness in a single-component system is of significance but remains challenging. Crystallization has been recognized to be a workable strategy to fulfill the above task. However, how the molecular packing mode affects the intersystem crossing and RTP lifetime concurrently remains unclear so far. Herein, four economic small-molecular compounds, analogues of the famous drug raloxifene (RALO), are facilely synthesized and further explored as neat single-component and stimuli-responsive RTP emitters via crystallization engineering. Thanks to their simple structures and high ease to crystallize, these raloxifene analogues function as models to clarify the important role of molecular packing in the RTP and stimuli-responsiveness properties. Thorough combination of the single-crystal structure analysis and theoretical calculations clearly manifests that the tight antiparallel molecular packing mode is the key point to their RTP behaviors. Interestingly, harnessing the controllable and reversible phase transitions of the two polymorphs of RALO-OAc driven by mechanical force, solvent vapor, and heat, a single-component multilevel stimuli-responsive platform with tunable emission color is established and further exploited for optical information encryption. This work would shed light on the rational design of multi-stimuli responsive RTP systems based on single-component organics.

Nutrient characteristics driven by multiple factors in large estuaries during summer: A case study of the Yangtze River Estuary.

Nutrients directly control the level of primary productivity and are crucial for the stability of marine ecosystems. Focusing on the survey results in August 2020 of the Yangtze River Estuary, this study elucidated the distribution characteristics and controlling factors of three nutrients: NO3-N, PO4-P, SiO3-Si. The results showed that the concentrations of NO3-N, PO4-P, SiO3-Si in the study area were generally higher near the shore than far shore, with average concentrations of 11.40, 0.70, and 23.73 µmol/L, respectively. The ocean currents drove the distribution of nutrients, and the transport of CDW and YSCC increased the nutrient levels. The resuspension of sediment caused by factors such as terrain and weather may lead to an abnormal increase in nutrients in the bottom waters. The main controlling factors of the three nutrients were different. NO3-N was significantly affected by human activities, PO4-P and SiO3-Si were mainly affected by natural factors.

Achieving Efficient Dark Blue Room-Temperature Phosphorescence with Ultra-Wide Range Tunable-Lifetime.

Tunable-lifetime room-temperature phosphorescence (RTP) materials have been widely studied due to their broad applications. However, only few reports have achieved wide-range lifetime modulation. In this work, ultra-wide range tunable-lifetime efficient dark blue RTP materials were realized by doping methyl benzoate derivatives into polyvinyl alcohol (PVA) matrix. The phosphorescence lifetimes of the doped films can be increased from 32.8 ms to 1925.8 ms. Such wide range of phosphorescence lifetime modulation is extremely rare in current reports. Moreover, the phosphorescence emission of the methyl 4-hydroxybenzoate-doped film is located in the dark blue region and the phosphorescence quantum yield reaches as high as 15.4 %, which broadens their applications in organic optoelectronic information. Further studies demonstrated that the reason for the tunable lifetime was that the magnitude of the electron-donating ability of the substituent group modulates the HOMO-LUMO and singlet-triplet energy gap of methyl benzoate derivatives, as well as the ability to non-covalent interactions with PVA. Moreover, the potential applications of luminescent displays and optical anti-counterfeiting of these high-performance dark blue RTP materials have been conducted.

Enhanced nitrogen removal performance of nitrogen-rich saline wastewater by marine anammox bacteria: Based on different influent loading strengths.

In an anaerobic sequential batch reactor (SBR), marine anammox bacteria (MAB) were able to enhance microbial activity in nitrogen-rich saline wastewater and it was significantly affected by influent substrate composition and loading strength. This study therefore enhanced nitrogen removal efficiency by adjusting the influent nitrogen loading strength of MAB-inoculated anaerobic SBRs and assessed the correlation with the bacterial community. The results displayed that the system obtained optimal nitrogen removal efficiency (TN = 83.52%, NH4-N = 90.14%, and NO2-N = 83.57%) as the strength of influent nitrogen loading was increased to 201.35 mg L-1 for NH4-N and 266.42 mg L-1 for NO2-N. Moreover, the increase in the strength of influent nitrogen loading also enhanced the anammox 16S rRNA abundance (4.09 × 108 copies g-1) and ladderanes content (22.49 ng g-1dw). Analysis of 15N isotope further illustrated that all systems were dominated by anammox (average ra = 95.22%). In conclusion, these findings provide scientific guidance for the management of eutrophic seawater and contribute to the realization of industrial applications for the treatment of nitrogen-rich saline wastewater.

Mutations highly specific for secondary AML are associated with poor outcomes in ELN favorable risk NPM1-mutated AML.

ABSTRACT: Acute myeloid leukemia (AML) is a heterogeneous malignancy with outcomes largely predicted by genetic abnormalities. Mutations of NPM1 are common in AML, occurring in ∼30% of cases, and generally considered a favorable risk factor. Mutations highly specific for secondary AML (sMut) have been shown to confer poor prognosis, but the overall impact of these mutations in the setting of favorable-risk AML defined by mutant NPM1 remains unclear. In this multicenter study of patients with AML (n = 233) with NPM1 mutation at diagnosis, we observed that patients with sMut had worse overall survival (OS) than those without sMut (15.3 vs 43.7 months; P = .002). Importantly, this finding persisted in the European LeukemiaNet (ELN) 2017-defined favorable risk subset (14.7 months vs not reached; P < .0001). Among patients who achieved NPM1 measurable residual disease (MRD) negativity, longer OS was observed in the entire cohort (P = .015) as well as in both the sMut subset (MRD negative: median OS (mOS) 73.9 months vs MRD positive: 12.3 months; P = .0170) and sMut ELN 2017-favorable subset (MRD negative: mOS 27.3 vs MRD positive: 10.5 months; P = .009). Co-occurrence of sMut and mutant NPM1 confers a poor prognosis in AML.

Novel porphyrin derivative containing cations as new photodynamic antimicrobial agent with high efficiency.

Bacterial infections from chronic wounds affect about 175 million people each year and are a significant clinical problem. Through the integration of photodynamic therapy (PDT) and chemotherapy, a new photosensitizer consisting of ammonium salt N,N-bis-(2-hydroxyethyl)-N-(6-(4-(10,15,20-trimesitylporphyrin-5-yl) phenoxy) hexane)-N-methanaminium bromide, TMP(+) was successfully synthesized with a total reaction yield of 10%. The novel photosensitizer consists of two parts, a porphyrin photosensitizer part and a quaternary ammonium salt part, to achieve the synergistic effect of photodynamic and chemical antibacterial activity. With the increase of TMP(+) concentration, the diameter of the PCT fiber membranes (POL/COL/TMP(+); POL, polycaprolactone; COL, collagen) gradually increased, which was caused by the charge of the quaternary ammonium salt. At the same time, the antibacterial properties were gradually improved. We finally selected the PCT 0.5% group for the antibacterial experiment, with excellent performance in fiber uniformity, hydrophobicity and biosafety. The antibacterial experiment showed that the modified porphyrin TMP(+) had a better antibacterial effect than others. In vivo chronic wound healing experiments proved that the antibacterial and anti-inflammatory effect of the PCTL group was the best, further confirmed by H&E histological analysis, immunofluorescence and immunohistochemistry mechanism experiments. This research lays the foundation for the manufacture of novel molecules that combine chemical and photodynamic strategies.

CDC-NET: a cell detection and confirmation network of bone marrow aspirate images for the aided diagnosis of AML.

Standardized morphological evaluation in pathology is usually qualitative. Classifying and qualitatively analyzing the nucleated cells in the bone marrow aspirate images based on morphology is crucial for the diagnosis of acute myoid leukemia (AML), acute lymphoblastic leukemia (ALL), and Myelodysplastic syndrome (MDS), etc. However, it is time-consuming and difficult to accurately identify nucleated cells and calculate the percentage of the cells because of the complexity of bone marrow aspirate images. This paper proposed a deep learning analysis model of bone marrow aspirate images, termed Cell Detection and Confirmation Network (CDC-NET), for the aided diagnosis of AML by improving the accuracy of cell detection and recognition. Specifically, we take the nucleated cells in the bone marrow aspirate images as the detection objects to establish the model. Since some cells from different categories have similar morphology, classification error is inevitable. We design a confirmation network in which multiple trained classifiers work as pathologists to confirm the cell category by a voting method. To demonstrate the effectiveness of the proposed approach, experiments on clinical microscopic datasets are conducted. The Recall and Precision of CDC-NET are 78.54% and 91.74% respectively, and the missed rate of our method is lower than those of the other popular methods. The experimental results demonstrated that the proposed model has the potential for the pathological analysis of aspirate smears and the aided diagnosis of AML.

Unraveling seasonal shifts in microbial and geochemical mediated arsenic mobilization at the estuarine sediment-water interface under redox changes.

The mobilization of arsenic (As) at the sediment-water interface (SWI) is crucial for determining the accumulation of dissolved As to potentially toxic levels. However, the specific impacts of redox processes involving iron (Fe) and sulfur (S), as well as microbial activities occurring in sediments, on As mobilization at the marine SWI remain poorly understood. In this study, we investigated As mobilization at the SWI in the Changjiang Estuary during three different seasons with different benthic redox conditions. The preferential reduction of arsenate (As(V)) to arsenite (As(III)) and subsequent re-adsorption onto newly formed crystalline Fe oxides restricted As release in the As(V) reduction layer. Enhanced Fe(III) reduction in the Fe(III) reduction layer contributed to As release, while the presence of low As-high Fe-high SO42- levels resulted in As removal through adsorption onto pyrite in the sulfate reduction layer. Analysis of functional genes indicated that As(V) in sediments was released into porewater through the reductive dissolution of As(V)-bearing Fe(III) oxides by Geobacter species, followed by microbial reduction of the liberated As(V) to As(III) by microbes carrying the arrA gene. The dominant pathway governing As mobilization at the SWI in the Changjiang Estuary shifted from microbial reduction control during the hypoxic summer to Fe redox control during the aerobic autumn and winter. These findings provide valuable insights into the complex mechanisms driving As mobilization and highlight the importance of considering seasonal variations in understanding As dynamics at the marine SWI.

Review and Updates on Systemic Mastocytosis and Related Entities.

Mast cell disorders range from benign proliferations to systemic diseases that cause anaphylaxis and other diverse symptoms to mast cell neoplasms with varied clinical outcomes. Mastocytosis is the pathologic process of the accumulation of abnormal mast cells in different organs, mostly driven by KIT mutations, and can present as cutaneous mastocytosis, systemic mastocytosis (SM), and mast cell sarcoma. The WHO 5th edition classification divides systemic mastocytosis into bone marrow mastocytosis, indolent systemic mastocytosis, smoldering systemic mastocytosis, aggressive systemic mastocytosis, systemic mastocytosis with an associated hematologic neoplasm, and mast cell leukemia. The new ICC classifies SM slightly differently. The diagnosis of SM requires the integration of bone marrow morphologic, immunophenotypic, and molecular findings, as well as clinical signs and symptoms. Moreover, understanding the wide range of clinical presentations for patients with mast cell disorders is necessary for accurate and timely diagnosis. This review provides an updated overview of mast cell disorders, with a special emphasis on SM, including the latest approaches to diagnosis, prognostic stratification, and management of this rare disease.