Atraumatic Splenic Rupture Due to Ectopic Extramedullary Hematopoiesis after Autologous Stem Cell Transplantation in a Patient with AL Amyloidosis

Intern Med. 2018 Feb 1;57(3):399-402. doi: 10.2169/internalmedicine.9018-17. Epub 2017 Nov 1.

Abstract

A 50-year-old man was diagnosed with multiple myeloma complicating AL amyloidosis. Splenic rupture was complicated during autologous stem cell transplantation (auto-SCT). Granulocyte colony-stimulating factor (G-CSF) was not administered. A pathological examination of the spleen revealed that CD34-positive cells were concentrated in the ruptured part of the splenic capsule. Hematopoietic cells were engrafted in the small gap between the capsule and amyloid protein deposition area of the spleen, which might have caused the splenic rupture in the absence of G-CSF administration. Special attention is thus required for amyloidosis patients undergoing auto-SCT, even when G-CSF is not administered.

Keywords: AL amyloidosis; autologous stem cell transplantation; granulocyte colony-stimulating factor; splenic rupture.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Bortezomib / therapeutic use*
  • Granulocyte Colony-Stimulating Factor
  • Hematopoiesis, Extramedullary
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Immunoglobulin Light-chain Amyloidosis / complications*
  • Immunoglobulin Light-chain Amyloidosis / drug therapy*
  • Male
  • Middle Aged
  • Multiple Myeloma / complications*
  • Multiple Myeloma / therapy
  • Splenic Rupture / drug therapy*
  • Splenic Rupture / etiology
  • Transplantation, Autologous / adverse effects*

Substances

  • Antineoplastic Agents
  • Granulocyte Colony-Stimulating Factor
  • Bortezomib