Pancytopenia due to hypersplenism after allogeneic bone marrow transplantation

Three patients developed pancytopenia in the second month post-allogeneic bone marrow transplantation in association with progressive splenomegaly and a normocellular marrow. Splenectomy resulted in a prompt and sustained improvement in all haematological parameters in all cases. None of the spleens had morphological or cytogenetic evidence of tumour. Hypersplenism should be considered in patients with persistent or recurrent pancytopenia and splenomegaly post-transplantation.