Spleen Enlargement Following Recombinant Human Granulocyte Colony-stimulating Factor Administration for Peripheral Blood Stem Cell Mobilization
Overview
Authors
Affiliations
Background And Objectives: Recombinant human granulocyte colony-stimulating factor (rhG-CSF) is widely used to mobilize peripheral blood stem cells (PBSC) for autologous or allogeneic transplants. Such treatment may cause spleen enlargement; exceptionally, spontaneous spleen rupture has been reported. We investigated changes in spleen size during stem cell mobilization.
Design And Methods: We evaluated spleen size, comparing palpation with ultrasound (US)-evaluated longitudinal diameter and volume, in 13 healthy donors and 22 patients with a hematological malignancy who were undergoing PBSC mobilization with rhG-CSF-including regimens.
Results: Intraobserver and interobserver variability of US-calculated spleen volume was very low; the correlation between the volume calculated by US and that measured by 3-dimensional computed tomography was excellent. During mobilization, spleen enlargement was detected by palpation in 17% of subjects, by US-measured longitudinal diameter in 60%, and by US-calculated volume in 91%. The median increase in spleen volume was 300 mL (range, 54-820; p<0.001) in healthy donors and 135 mL (range, 0-413; p=0.004) in the group of patients; the enlargement correlated with white blood cell count elevation (p=0.016) but not with circulating CD34+ cells. One month after the last administration of rhG-CSF, the median decrease was 160 mL (range, 35-800) in healthy donors and 58 mL (range, 0-310) in patients.
Interpretation And Conclusions: When evaluated by sensitive methods, rhG-CSF caused spleen enlargement in almost all individuals treated. US-calculated volume proved to be an excellent method, much better than longitudinal diameter, for detecting non-palpable splenomegaly induced by rhG-CSF.
Pugliese N, Cavaliere C, Basso L, Fazio L, Malafronte R, Giordano C Ann Hematol. 2025; 104(1):383-388.
PMID: 39836191 PMC: 11868251. DOI: 10.1007/s00277-024-06177-x.
Groenen A, La Rose A, Li M, Bazioti V, Svendsen A, Kloosterhuis N J Lipid Res. 2022; 63(2):100167.
PMID: 35007562 PMC: 8953690. DOI: 10.1016/j.jlr.2021.100167.
Kitamura N, Sento S, Sasabe E, Kiyasu K, Nakaji K, Daibata M Mol Clin Oncol. 2021; 15(4):202.
PMID: 34462658 PMC: 8375029. DOI: 10.3892/mco.2021.2364.
Hasan S, Dmitriew M, Leonard J Case Reports Hepatol. 2020; 2020:8893713.
PMID: 33381333 PMC: 7762672. DOI: 10.1155/2020/8893713.
Pilatova K, Bencsikova B, Demlova R, Valik D, Zdrazilova-Dubska L Cancer Immunol Immunother. 2018; 67(12):1919-1929.
PMID: 29748897 PMC: 11028306. DOI: 10.1007/s00262-018-2166-4.