title: Spontaneous splenic haematoma in a multiple myeloma patient receiving pegfilgrastim support.
abstract: Growth factors are a significant advance in the supportive care of patients with cancer with a wide range of indications. Frequent side effects of G-CSF include bone pain, headache, fatigue and nausea. We report a case of subcapsular splenic haematoma following pegfilgrastim administration in a 65-year old patient with multiple myeloma. Proposed mechanisms accounting for splenic enlargement include extramedullary haemopoiesis, intrasplenic infiltration by mature and immature myeloid cells and intrasplenic stem cell homing and proliferation. The risk of spontaneous splenic rupture is difficult to quantify. Physicians should be aware of this life-threatening condition and early diagnosis can be difficult since anemia and splenomegaly are common findings in haematologic patients.
authors.affiliation: Haematology Clinic, University Hospital of Ioannina, 20 Ka;pakiou Str., 45-445 Ioannina, Greece. eleftheria.chatzimichail@medai.gr
authors.forename: E
authors.initials: E
authors.lastname: Hatzimichael
authors.forename: L
authors.initials: L
authors.lastname: Benetatos
authors.forename: J
authors.initials: J
authors.lastname: Stebbing
authors.forename: E
authors.initials: E
authors.lastname: Kapsali
authors.forename: S
authors.initials: S
authors.lastname: Panayiotopoulou
authors.forename: K L
authors.initials: KL
authors.lastname: Bourantas
mesh_terms: D000368:Aged; D000740:Anemia / Q000209:etiology; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy*; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012422:Rupture, Spontaneous / Q000209:etiology / Q000601:surgery; D013161:Splenic Rupture / Q000097:blood / Q000209:etiology* / Q000601:surgery
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim