title: Spontaneous splenic rupture following administration of granulocyte colony-stimulating factor (G-CSF): occurrence in an allogeneic donor of peripheral blood stem cells.
abstract: Granulocyte colony-stimulating factor (G-CSF) has been used to improve granulocyte count in chronic neutropenia and myelodysplasia, to minimize the incidence and duration of neutropenia during conventional chemotherapy, and to mobilize peripheral blood stem cells prior to leukapheresis for use in autologous and allogeneic marrow transplantation. The most common toxicity is bone pain, and other reactions such as inflammation at the site of injection have also occurred. In patients with chronic neutropenia, splenomegaly has been described with long-term use, and extramedullary hematopoiesis has also been reported. However, thus far, no life-threatening sequelae of these effects are found in the literature. We now describe a case of spontaneous splenic rupture four days following a six-day course of G-CSF therapy in an allogeneic donor of peripheral blood stem cells.
authors.affiliation: Department of Medicine, University of Massachusetts Medical Center, Worcester 01655, USA.
authors.forename: P S
authors.initials: PS
authors.lastname: Becker
authors.forename: M
authors.initials: M
authors.lastname: Wagle
authors.forename: S
authors.initials: S
authors.lastname: Matous
authors.forename: R S
authors.initials: RS
authors.lastname: Swanson
authors.forename: G
authors.initials: G
authors.lastname: Pihan
authors.forename: P A
authors.initials: PA
authors.lastname: Lowry
authors.forename: F M
authors.initials: FM
authors.lastname: Stewart
authors.forename: S O
authors.initials: SO
authors.lastname: Heard
mesh_terms: D000208:Acute Disease; D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D001782:Blood Donors; D016026:Bone Marrow Transplantation; D003937:Diagnosis, Differential; D005334:Fever / Q000150:complications; D016044:Fusion Proteins, bcr-abl / Q000032:analysis; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects*; D006411:Hematopoiesis, Extramedullary / Q000187:drug effects*; D018380:Hematopoietic Stem Cell Transplantation; D006465:Hemoperitoneum / Q000209:etiology; D006566:Herpesviridae Infections / Q000175:diagnosis; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D007937:Leukapheresis; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis; D007951:Leukemia, Myeloid / Q000628:therapy; D008297:Male; D011030:Pneumothorax / Q000150:complications; D012008:Recurrence; D012128:Respiratory Distress Syndrome / Q000150:complications; D012422:Rupture, Spontaneous; D013156:Splenectomy; D013161:Splenic Rupture / Q000139:chemically induced* / Q000601:surgery; D013163:Splenomegaly / Q000139:chemically induced / Q000175:diagnosis; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D014408:Biomarkers, Tumor; D016179:Granulocyte Colony-Stimulating Factor; D016044:Fusion Proteins, bcr-abl