Splenic rupture after granulocyte–colony‐stimulating factor mobilization in a peripheral blood progenitor cell donor

Splenic rupture in a patient with plasma cell myeloma following G-CSF/GM-CSF administration for stem cell transplantation and review of the literature

“…16 The splenomegaly has been attributed to infiltration of the red pulp by granulocytes in some cases as well as the presence of extramedullary hematopoiesis in others. Although splenomegaly seems to be a common side effect, there are only occasional cases of splenic rupture reported and we have attempted to identify all cases of splenic rupture related to G-CSF/GM-CSF therapy reported in the English literature (Table 1) [2][3][4][5][6][7][8][9][10][11][12][13] with an additional case from our institution. Recently, a similar study was published by Nuamah et al, 12 but it does not include all published cases.…”

“…As noted in Table 1, there is a broad range of underlying disorders with most being hematologic. [2][3][4][5][6][7][8][9][10][11][12][13] The splenic rupture occurred not only in patients with underlying hematopoietic disorders, but also in patients with solid tumors and healthy donors. Most patients experienced malaise, pain radiating to the left shoulder, drop in blood pressure and decrease in hematocrit.…”

“…The salient features of all cases with splenic rupture involving G-CSF/GM-CSF treatment that have been reported in the English literature are summarized in Table 1. [2][3][4][5][6][7][8][9][10][11][12][13] The cases include individuals receiving G-CSF/GM-CSF for neutropenia, patients being prepared for autologous stem cell transplant and donors undergoing PBPC mobilization. Of note is the fact that spontaneous splenic ruptures occurred not only in diseased patients, but also in healthy donors.…”

Benign extramedullary myeloid proliferations

“…[9][10][11] This is because of the induction of EMH, which can under extreme circumstances cause splenic rupture. 12,13 Hematopoietic cytokines have also been associated with EMH in other sites, including lymph nodes. [14][15][16] …”

Regenerative Cell Therapy After Myocardial Infarction: Cells or Growth Factors?

“…Although the use of hematopoietic growth factors, mainly G-CSF, is customary practice in hematology and oncology, the incidence of splenic ruptures is very low. 17 Most hematologists and oncologists will see hundreds of patients treated with G-CSF during their career, but will never see a case of splenic rupture. On the other hand, in Suárez de Lezo's study the incidence was 8%.…”