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

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015 Jun;159(2):294-8. doi: 10.5507/bp.2013.086. Epub 2013 Nov 26.

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.

Keywords: abdominal pain; acute promyelocytic leukaemia; splenic rupture; splenomegaly.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

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