Splenic rupture in children with hematologic malignancies

Athale, Uma H.; Kaste, C D O Sue; Bodner, Sara M.; Ribeiro, Raul C.

doi:10.1002/(sici)1097-0142(20000115)88:2<480::aid-cncr31>3.0.co;2-i

Cited by 25 publications

(15 citation statements)

References 18 publications

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“…The possible mechanisms suggested thus far include splenic enlargement, leukemic blasts infiltration of the splenic capsule, splenic infarction resulting in capsular hemorrhage, and leukemia-associated coagulopathy 8. Male patients, patients above 20 years of age, patients displaying splenomegaly, and those who have recently undergone cytoreductive chemotherapy appear to be at higher risk of suffering a pathologic rupture 1…”

Section: Discussionmentioning

confidence: 99%

A Case of Pathologic Splenic Rupture as the Initial Manifestation of Acute Myeloid Leukemia M2

Han

Kim

et al. 2010

Yonsei Med J

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A pathologic splenic rupture refers to a rupture without trauma. A splenic rupture as the initial manifestation of acute myeloid leukemia is extremely rare. In this study, we described a rare case of acute myeloid leukemia presenting principally as an acute abdomen due to a pathologic splenic rupture in a 35-year old male patient. We can assert that a pathologic splenic rupture in hematologic diseases is a potentially life-threatening complication, which necessitates immediate operative intervention. Any such patient complaining about left upper abdominal tenderness should be closely observed, and further diagnostic investigations (ultrasonograph of the abdomen, abdominal CT scan) should be initiated in order to rule out a splenic rupture. The oncologist should be aware of this rare initial presentation of acute myeloid leukemia (AML) M2, as the condition generally necessitates a prompt splenectomy.

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Section: Discussionmentioning

confidence: 99%

A Case of Pathologic Splenic Rupture as the Initial Manifestation of Acute Myeloid Leukemia M2

Han

Kim

et al. 2010

Yonsei Med J

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“…The suggested mechanism of splenic rupture in malignancy includes splenic enlargement, splenic and capsular infiltration by lymphoma, and eventual splenic infarction leading to capsular hemorrhage [1, 5, 11, 12]. Although splenic enlargement itself poses the greatest risk for potential splenic rupture, other factors have been postulated to account for such occurrences [1, 11].…”

Section: Discussionmentioning

confidence: 99%

“…The risk of splenic rupture increases dramatically with age. This observation is most likely related to the difference in hematologic cell types and anatomical abnormalities rendering the spleen more vulnerable [11, 12]. Induction chemotherapy directed towards the preexisting malignancy may also be a potential risk factor for splenic rupture.…”

Section: Discussionmentioning

confidence: 99%

“…This is especially true with Aspergillus spp. which are angioinvasive organisms causing erosion and occlusion of blood vessels, thereby increasing the risk for splenic rupture [12]. Variation in specific subtypes of MCL, male sex, and aggressiveness of disease have also been thought to be additional risks for splenic rupture in patients with MCL [1, 8, 11–13].…”

Section: Discussionmentioning

confidence: 99%

“…Athale et al suggested that improved imaging techniques and increased utilization of imaging studies may account for a rise in incidental detection of “preclinical” splenic rupture. Surveillance imaging using ultrasound or CT scanning for the presence of a “sentinel clot” in patients with hematologic malignancies is therefore recommended [12]. …”

Section: Discussionmentioning

confidence: 99%

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Pathologic Rupture of the Spleen in Mantle-Cell-Type Non-Hodgkin’s Lymphoma

Tan

Rajan

Majeed

et al. 2012

Case Reports in Medicine

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Mantle cell lymphoma (MCL) accounts for less than 10 percent of all non-Hodgkin’s lymphoma (NHL). Pathologic or spontaneous rupture of the spleen has been reported in patients with lymphoma; however only 5 cases have been reported in patients with MCL. Although splenomegaly occurs frequently in patients with MCL, spontaneous splenic rupture is rare. We present a case of a 51-year-old female with MCL, who presented to the medical emergency room with splenic rupture. This case illustrates that clinicians should be aware of the incidence and presentation of patients with MCL and spontaneous splenic rupture, as early detection and heightened suspicion may prevent potentially fatal outcomes.

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Partial splenic embolization for cancer patients with thrombocytopenia requiring systemic chemotherapy

Kauffman

Mahvash

Kopetz

et al. 2008

Cancer

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BACKGROUND. Partial splenic embolization (PSE) has been used to improve hematologic parameters related to hypersplenism. The purpose of this study was to review our institutional experience with PSE for cancer patients with thrombocytopenia because of splenic sequestration precluding the administration of systemic therapy (ST). METHODS. A retrospective review of cancer patients undergoing PSE was undertaken. Twenty‐eight patients underwent PSE to correct thrombocytopenia to facilitate the initiation or resumption of ST. Primary and secondary endpoints of the current study included a platelet count increase > 150 K/UL and the initiation of ST, respectively. Periprocedural laboratory values and adverse events were recorded. RESULTS. Thirty PSEs were performed in 28 patients. Two patients underwent repeat PSE because of recurrent thrombocytopenia after the successful initiation of ST. For procedures with adequate follow‐up, primary and secondary endpoints were achieved in 96.3% (26 of 27 patients) and 95.7% (22 of 23 patients) of patients, respectively. The mean platelet count was 81 K/UL immediately before PSE and peaked at 293 K/UL after PSE. For 23 patients with frequent laboratory follow‐up, the mean time to a platelet count > 150 K/UL was 10 days. The mean hospital stay was 4.5 days. Postprocedure abdominal pain occurred in all patients. Fever was documented in 16 patients and pulmonary consolidation/atelectasis or effusion was documented in 10 patients; 9 patients received empiric antibiotic coverage. The median overall survival was 9.40 months (95% confidence interval, 8.2–10.7 months) among the 28 patients after PSE. CONCLUSIONS. PSE is a safe and effective means of managing thrombocytopenia secondary to hypersplenism to facilitate the administration of ST in patients with cancer. Cancer 2008. © 2008 American Cancer Society.

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Splenic rupture in children with hematologic malignancies

Cited by 25 publications

References 18 publications

A Case of Pathologic Splenic Rupture as the Initial Manifestation of Acute Myeloid Leukemia M2

A Case of Pathologic Splenic Rupture as the Initial Manifestation of Acute Myeloid Leukemia M2

Pathologic Rupture of the Spleen in Mantle-Cell-Type Non-Hodgkin’s Lymphoma

Partial splenic embolization for cancer patients with thrombocytopenia requiring systemic chemotherapy

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