Definition of standards for allergology specialty/subspecialty training in mast cell disorders, in Europe: a EAACI position paper

Mast cell disorders (MCD), including mastocytosis and mast cell (MC) activation syndrome (MCAS), encompass a heterogeneous spectrum of diseases often presenting with debilitating manifestations. Variable clinical manifestations, ranging from otherwise asymptomatic cutaneous forms to recurrent anaphylaxis, pose significant challenges for timely diagnosis and effective management. Despite increasing recognition of MCD in Europe, diagnosis is frequently delayed, and therapeutic approaches remain inconsistent, potentially due to gaps and disparities in training. An European Academy of Allergy and Clinical Immunology (EAACI) Task Force (TF) was created to address this need. Through iterative consensus, the TF members formulated ten expert-based recommendations outlining the minimum competencies that allergology and clinical immunology trainees should acquire regarding MCD. These include fundamental knowledge of MC biology, pathogenesis of clonality, recognition of systemic manifestations, diagnostic methodologies, pharmacological and preventive strategies, management of comorbid Hymenoptera venom allergy, pediatric aspects, communication skills, and how to acquire and consolidate expertise. This position paper underscores the need for harmonized competency-based training standards on MCD for Allergists and Clinical Immunologists across Europe. We advocate for the incorporation of these recommendations into national postgraduate curricula, aiming to foster earlier recognition, improve management, and ultimately enhance long-term outcomes for MCD patients.