Spontaneous splenic rupture in a patient with acute promyelocytic leukaemia during induction chemotherapy.

Abstract

BACKGROUND:

Acute promyelocytic leukaemia (APL) is a subtype of acute myeloid leukaemia with high curability rates. However, it is often accompanied by severe coagulopathy and bleeding risk and thus represents a potentially fatal haematological emergency requiring immediate treatment. Spontaneous splenic rupture is a rare event in all haematological malignancies. Only two clinical cases have been described so far in a setting of APL.

CASE REPORT:

We report a patient with APL without preceding splenomegaly who underwent urgent splenectomy for spontaneously occurring splenic rupture during induction chemotherapy. After surgery the patient completed induction chemotherapy and achieved complete remission.

CONCLUSION:

This is the second case of spontaneous splenic rupture without preceding splenomegaly in a patient with APL during induction chemotherapy described so far. Our case demonstrates that emergent splenectomy can be lifesaving even in the unfavourable condition of patient with severe immune deficiency.

• Authors: Adam Kuba, Tomas Szotkowski, Peter Rohon, Edgar Faber, Peter Turcsanyi, Jaromir Hubacek, Milena Holzerova, Vojtech Prasil, Marie Jarosova, Karel Indrak
• Journal: Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia (Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub) Vol. 159 Issue 2 Pg. 294-8 (Jun 2015) ISSN: 1804-7521 [Electronic] Czech Republic
• PMID: 24322341 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Emergency Treatment
• Hemorrhage (etiology, surgery)
• Humans
• Induction Chemotherapy
• Leukemia, Promyelocytic, Acute (complications, drug therapy)
• Male
• Middle Aged
• Rupture, Spontaneous (etiology, surgery)
• Splenectomy
• Splenic Rupture (etiology, surgery)