title: Splenectomy for hypersplenism caused by adult T-cell leukemia: report of a case.
abstract: A 45-year-old woman with previously diagnosed chronic type adult T-cell leukemia (ATL) presented with abdominal discomfort and red eruptions on her arms and legs. Anemia, thrombocytopenia, hypercalcemia, and splenomegaly indicated progression to acute-type ATL. Combined chemotherapy resulted in normalization of the serum calcium level and improvement in her symptoms. However, the severe anemia and thrombocytopenia persisted, necessitating transfusions of red blood cells (RBC) and platelets three times a week. We performed splenectomy in an attempt to reduce the total volume of malignant cells and improve the hypersplenism. After the operation, the RBC and platelet counts increased gradually, and the transfusions were stopped on postoperative day (POD) 3. Splenectomy should be considered as an optional treatment for hypersplenism caused by ATL when hypersplenism cannot be controlled by chemotherapy in patients without a high surgical risk.
authors.affiliation: Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Endo
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohta
authors.forename: Kohei
authors.initials: K
authors.lastname: Shibata
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Kai
authors.forename: Kentaro
authors.initials: K
authors.lastname: Iwaki
authors.forename: Hiroki
authors.initials: H
authors.lastname: Uchida
authors.forename: Masao
authors.initials: M
authors.lastname: Ogata
authors.forename: Junji
authors.initials: J
authors.lastname: Ikewaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Kashima
authors.forename: Seigo
authors.initials: S
authors.lastname: Kitano
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018450:Disease Progression; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D006971:Hypersplenism / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008875:Middle Aged; D017713:Platelet Transfusion; D013154:Spleen / Q000473:pathology; D013156:Splenectomy; D013163:Splenomegaly