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Related Experiment Videos

Splenic rupture in children with hematologic malignancies.

U H Athale1, S C Kaste, S M Bodner

  • 1Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.

Cancer
|January 21, 2000
PubMed
Summary

Splenic rupture in children with hematologic malignancies is rare but serious. Improved imaging has increased detection rates, with fungal infections potentially playing a role in pathogenesis.

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Area of Science:

  • Pediatric Hematology/Oncology
  • Medical Imaging
  • Infectious Diseases

Background:

  • Splenic rupture is a rare but life-threatening complication in adult leukemias and lymphomas.
  • This study investigates splenic rupture frequency and outcomes in pediatric hematologic malignancies.

Observation:

  • Seven pediatric patients (ages 5-17) with hematologic malignancies experienced splenic rupture.
  • Five cases occurred in the recent era (1991-1997) compared to two in the early era (1962-1990).
  • Four patients had concurrent fungal infections.

Findings:

  • The overall detection rate of splenic rupture was 0.18%, increasing 9-fold in the recent era (0.55%) versus the early era (0.06%).
  • Conservative management was successful for all seven cases.

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  • Risk factors include adolescent age, acute myeloid leukemia, high leukocyte count, thrombocytopenia, and coagulopathy.

    • Implications:

    • Increased use of advanced imaging techniques likely accounts for higher detection of "preclinical" splenic rupture.
    • Fungal infections may be implicated in the pathogenesis of splenic rupture in this population.
    • Early detection and conservative management are key for pediatric splenic rupture in hematologic malignancies.