Sato Shuku, Tamai Yotaro, Okada Satomi, Kannbe Emiko, Takeda Kotaro, Tanaka Eri
Division of Hematology, Shonan Kamakura General Hospital, Japan.
Department of Pathology, Shonan Kamakura General Hospital, Japan.
Intern Med. 2018 Feb 1;57(3):399-402. doi: 10.2169/internalmedicine.9018-17. Epub 2017 Nov 1.
A 50-year-old man was diagnosed with multiple myeloma complicating AL amyloidosis. Splenic rupture was complicated during autologous stem cell transplantation (auto-SCT). Granulocyte colony-stimulating factor (G-CSF) was not administered. A pathological examination of the spleen revealed that CD34-positive cells were concentrated in the ruptured part of the splenic capsule. Hematopoietic cells were engrafted in the small gap between the capsule and amyloid protein deposition area of the spleen, which might have caused the splenic rupture in the absence of G-CSF administration. Special attention is thus required for amyloidosis patients undergoing auto-SCT, even when G-CSF is not administered.
一名50岁男性被诊断为多发性骨髓瘤合并AL淀粉样变性。在自体干细胞移植（auto-SCT）期间并发脾破裂。未给予粒细胞集落刺激因子（G-CSF）。脾脏病理检查显示，CD34阳性细胞集中在脾包膜破裂部位。造血细胞植入到脾包膜与淀粉样蛋白沉积区域之间的小间隙中，这可能是在未给予G-CSF的情况下导致脾破裂的原因。因此，对于接受auto-SCT的淀粉样变性患者，即使未给予G-CSF，也需要特别关注。
