title: Spontaneous splenic rupture following stem cell mobilization with G-CSF and plerixafor in AL amyloidosis.
abstract: BACKGROUND
  AL amyloidosis is a rare plasma cell dyscrasia with multiorgan involvement. Good risk patients are candidate to high dose chemotherapy and autologous stem cell transplantation. However both transplantation and stem cell collection entail significant risk in such patients. Plerixafor is a novel mobilizing agent approved for use in "poor mobilizer" patients with lymphoma and multiple myeloma; experience in systemic amyloidosis patients is limited.
  
  
  METHODS
  We describe a case of spontaneous splenic rupture following administration of G-CSF and plerixafor in a patient with AL amyloidosis who previously underwent heart transplantation due to amyloid heart involvement.
  
  
  CONCLUSIONS
  This is the first report of spontaneous splenic rupture following stem cell mobilization with G-CSF and plerixafor in AL amyloidosis. The role of plerixafor has to be established. AL amyloidosis patients undergoing stem cell mobilization need careful monitoring of signs and symptoms of spontaneous splenic rupture.
authors.affiliation: Hematology and Clinical Immunology, Department of Medicine, University of Padova, Padova, Italy. Electronic address: lessi.federica@gmail.com.
authors.forename: Federica
authors.initials: F
authors.lastname: Lessi
authors.affiliation: Blood Transfusion Unit, Padova University Hospital, Padova, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Marson
authors.affiliation: Blood Transfusion Unit, Padova University Hospital, Padova, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Colpo
authors.affiliation: Pathology Unit, Department of Laboratory Medicine, University of Padova, Padova, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Marino
authors.affiliation: Hematology and Clinical Immunology, Department of Medicine, University of Padova, Padova, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Branca
authors.affiliation: Blood Transfusion Unit, Padova University Hospital, Padova, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Tison
authors.affiliation: Hematology and Clinical Immunology, Department of Medicine, University of Padova, Padova, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Adami
mesh_terms: D000328:Adult; D000686:Amyloidosis / Q000473:pathology / Q000628:therapy*; D001596:Benzylamines; D000080027:Cyclams; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects*; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects*; D006571:Heterocyclic Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D012422:Rupture, Spontaneous; D013161:Splenic Rupture / Q000209:etiology* / Q000473:pathology
chemical_list: D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor
keywords: Amyloidosis; G-CSF; Mobilization; Plerixafor; Spleen rupture