Kuba Adam, Szotkowski Tomas, Rohon Peter, Faber Edgar, Turcsanyi Peter, Hubacek Jaromir, Holzerova Milena, Prasil Vojtech, Jarosova Marie, Indrak Karel
Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic.
Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015 Jun;159(2):294-8. doi: 10.5507/bp.2013.086. Epub 2013 Nov 26.
Acute promyelocytic leukaemia (APL) is a subtype of acute myeloid leukaemia with high curability rates. However, it is often accompanied by severe coagulopathy and bleeding risk and thus represents a potentially fatal haematological emergency requiring immediate treatment. Spontaneous splenic rupture is a rare event in all haematological malignancies. Only two clinical cases have been described so far in a setting of APL.
We report a patient with APL without preceding splenomegaly who underwent urgent splenectomy for spontaneously occurring splenic rupture during induction chemotherapy. After surgery the patient completed induction chemotherapy and achieved complete remission.
This is the second case of spontaneous splenic rupture without preceding splenomegaly in a patient with APL during induction chemotherapy described so far. Our case demonstrates that emergent splenectomy can be lifesaving even in the unfavourable condition of patient with severe immune deficiency.
急性早幼粒细胞白血病（APL）是急性髓系白血病的一种亚型，治愈率较高。然而，它常伴有严重的凝血功能障碍和出血风险，因此是一种潜在致命的血液学急症，需要立即治疗。自发性脾破裂在所有血液系统恶性肿瘤中均属罕见事件。迄今为止，仅报道过两例APL患者发生自发性脾破裂的临床病例。
我们报告1例APL患者，该患者在诱导化疗期间发生自发性脾破裂，此前并无脾肿大，遂接受了急诊脾切除术。术后，患者完成了诱导化疗并实现完全缓解。
这是迄今为止报道的第二例APL患者在诱导化疗期间发生自发性脾破裂且此前并无脾肿大的病例。我们的病例表明，即使在患者存在严重免疫缺陷这种不利情况下，急诊脾切除术也可能挽救生命。
