Splenic artery embolization as emergency treatment of splenic rupture in a child with T‐cell acute lymphocytic leukemia having t(8;14) translocation

Gardner, Renée V.; Warrier, R. P.; Loe, William A.; Ward, Kenneth; Haymon, Marie Louise; Craver, Randall

doi:10.1002/mpo.10372

Cited by 9 publications

(6 citation statements)

References 5 publications

(1 reference statement)

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“…PSE has become an accepted and effective alternative to splenectomy for the management of hypersplenism in various disease contexts. These include hematologic abnormalities or malignancies that directly involve the spleen7, 8, 11, 15–17 and entities that result in portal hypertension or venous congestion 9, 10, 18–22. Twelve patients in the current study had an identifiable cause of portal hypertension, including diagnoses of cirrhosis or portal venous system compromise.…”

Section: Discussionmentioning

confidence: 95%

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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Section: Discussionmentioning

confidence: 95%

Partial splenic embolization for cancer patients with thrombocytopenia requiring systemic chemotherapy

Kauffman

Mahvash

Kopetz

et al. 2008

Cancer

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“…Madoff et al S195 spherocytosis (24 -27); and diffuse splenic infiltration from primary malignancies such as leukemia and lymphoma (28,29). Signs of hypersplenism include splenomegaly, thrombocytopenia, leukopenia, and anemia, and symptoms may include abdominal discomfort, pain, respiratory distress, and early satiety (30,31).…”

Section: Rg F Volume 25 • Special Issuementioning

confidence: 97%

Splenic Arterial Interventions: Anatomy, Indications, Technical Considerations, and Potential Complications

Madoff

Denys

Wallace³

et al. 2005

RadioGraphics

257

189

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Splenic arterial interventions are increasingly performed to treat various clinical conditions, including abdominal trauma, hypersplenism, splenic arterial aneurysm, portal hypertension, and splenic neoplasm. When clinically appropriate, these procedures may provide an alternative to open surgery. They may help to salvage splenic function in patients with posttraumatic injuries or hypersplenism and to improve hematologic parameters in those who otherwise would be unable to undergo high-dose chemotherapy or immunosuppressive therapy. Splenic arterial interventions also may be performed to exclude splenic artery aneurysms from the parent vessel lumen and prevent aneurysm rupture; to reduce portal pressure and prevent sequelae in patients with portal hypertension; to treat splenic artery steal syndrome and improve liver perfusion in liver transplant recipients; and to administer targeted treatment to areas of neoplastic disease in the splenic parenchyma. As the use of splenic arterial interventions increases in interventional radiology practice, clinicians must be familiar with the splenic vascular anatomy, the indications and contraindications for performing interventional procedures, the technical considerations involved, and the potential use of other interventional procedures, such as radiofrequency ablation, in combination with splenic arterial interventions. Familiarity with the complications that can result from these interventional procedures, including abscess formation and pancreatitis, also is important.

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“…In three published cases with APL and most cases with other types of acute leukaemia, patients were successfully treated with an immediate splenectomy [1]. Some literature research revealed that TAE of the splenic artery was performed in a few patients with haematological malignancies [7] [12] [13] [14]. Considering the poor coagulation status of the patient, the expected bone marrow aplasia after induction therapy and COVID-19 infection, splenectomy was estimated as a high-risk intervention in our patient.…”

Section: Disscusionmentioning

confidence: 99%

Successful Treatment of Spontaneous Rupture of the Spleen by Embolization of Splenic Artery in a Patient with Acute Promyelocytic Leukaemia and COVID-19 Infection

Marković¹,

Divac²,

Lukić³

et al. 2021

OJEM

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Spontaneous rupture of the spleen (SRS) is a rare clinical entity with a potentially poor medical outcome. In most cases, SRS is caused by neoplastic disorder. Acute promyelocytic leukaemia is a rare but important cause of SRS that physicians are required to assess for. We present a 28-year-old woman with APL and COVID-19 pneumonia, who successfully underwent embolisation of the splenic artery for spontaneously occurring splenic rupture during induction chemotherapy. After the intervention the patient completed induction chemotherapy and achieved complete remission. Our case demonstrates that emergent transcatheter arterial embolisation can be lifesaving even in the unfavourable condition of a patient with severe immune deficiency.

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Splenic artery embolization as emergency treatment of splenic rupture in a child with T‐cell acute lymphocytic leukemia having t(8;14) translocation

Cited by 9 publications

References 5 publications

Partial splenic embolization for cancer patients with thrombocytopenia requiring systemic chemotherapy

Partial splenic embolization for cancer patients with thrombocytopenia requiring systemic chemotherapy

Splenic Arterial Interventions: Anatomy, Indications, Technical Considerations, and Potential Complications

Successful Treatment of Spontaneous Rupture of the Spleen by Embolization of Splenic Artery in a Patient with Acute Promyelocytic Leukaemia and COVID-19 Infection

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