Powiększenie śledziony (splenomegalia) – Rokowania, prognozy i postęp choroby

Powiększenie śledziony (splenomegalia)
Rokowania, prognozy i postęp choroby

Powiększenie śledziony (splenomegalia) jest objawem wtórnym, a rokowanie zależy głównie od choroby podstawowej, a nie od samej splenomegalii. Przejściowa splenomegalia zwykle nie wpływa negatywnie na stan pacjenta, natomiast przewlekła może prowadzić do uszkodzenia narządu i cytopenii (niedokrwistość, leukopenia, małopłytkowość) wskutek nadmiernej aktywności śledziony. Istotnym powikłaniem jest ryzyko pęknięcia śledziony nawet przy niewielkich urazach, co wymaga pilnej interwencji chirurgicznej. W niektórych schorzeniach, np. u pacjentów z ostrą białaczką szpikową (AML) poddawanych allogenicznemu przeszczepieniu komórek macierzystych (HSCT), większa objętość śledziony koreluje z gorszymi wynikami leczenia: całkowite przeżycie po 2 latach wynosi 55,7% vs. 66,6%, a śmiertelność niezwiązana z nawrotem choroby 28,8% vs. 20,2%.

Ogólne informacje o prognozie w przypadku powiększenia śledziony
Czynniki wpływające na rokowanie

Choroba podstawowa
Czas trwania splenomegalii
Wielkość śledziony

Potencjalne powikłania wpływające na rokowanie
Rokowanie po usunięciu śledziony
Monitorowanie i kontrola medyczna
Wnioski prognostyczne

Kolejne rozdziały

Ogólne informacje o prognozie w przypadku powiększenia śledziony

Powiększenie śledziony (splenomegalia) jest objawem choroby podstawowej, a nie samodzielnym schorzeniem. Prognoza dla pacjentów z powiększoną śledzioną zależy przede wszystkim od przyczyny leżącej u podłoża tego stanu, a nie od samej splenomegalii.¹ W większości przypadków rokowanie jest doskonałe i nie różni się znacząco od rokowania w odpowiedniej grupie wiekowej bez splenomegalii, pod warunkiem odpowiedniego leczenia choroby podstawowej.²³

Warto jednak zaznaczyć, że niezależnie od etiologii powiększenia śledziony, ryzyko jej pęknięcia jest znacznie podwyższone nawet przy niewielkich urazach jamy brzusznej czy dolnej części klatki piersiowej.⁴⁵ Jest to poważne powikłanie, które może prowadzić do zagrażającego życiu krwawienia wewnętrznego i konieczności pilnej splenektomii.⁶

Czynniki wpływające na rokowanie

Choroba podstawowa

Najbardziej istotnym czynnikiem determinującym rokowanie u pacjentów z powiększoną śledzioną jest choroba podstawowa powodująca splenomegalię.⁷ Śledziona może powiększać się w przebiegu wielu różnych schorzeń, od łagodnych infekcji (które zazwyczaj wiążą się z dobrym rokowaniem) po poważne choroby hematologiczne i nowotworowe (które mogą znacząco wpływać na długość i jakość życia pacjenta).

Czas trwania splenomegalii

Przejściowe powiększenie śledziony zazwyczaj nie ma negatywnego wpływu na ogólny stan zdrowia pacjenta. Jednak przewlekła splenomegalia może prowadzić do uszkodzenia narządu i zwiększać ryzyko powikłań.⁸ Długotrwale powiększona śledziona może stać się nadmiernie aktywna, co prowadzi do wychwytywania lub usuwania zbyt dużej liczby komórek krwi z krążenia, powodując niedokrwistość, leukopenię lub małopłytkowość.⁹

Wielkość śledziony

Stopień powiększenia śledziony może mieć znaczenie prognostyczne w niektórych schorzeniach. Na przykład, w przypadku pacjentów z ostrą białaczką szpikową (AML) poddawanych allogenicznemu przeszczepieniu komórek macierzystych (HSCT), większa objętość śledziony w momencie przeszczepu jest niezależnie związana z gorszymi wynikami leczenia.¹⁰ Badania wykazały, że zwiększona objętość śledziony wiąże się z niższym całkowitym przeżyciem po HSCT (55,7% vs. 66,6% po 2 latach) oraz wyższym skumulowanym wskaźnikiem śmiertelności niezwiązanej z nawrotem choroby (28,8% vs. 20,2% po 2 latach).¹¹

Potencjalne powikłania wpływające na rokowanie

Powiększona śledziona może prowadzić do szeregu powikłań, które mają wpływ na rokowanie pacjenta:

Pęknięcie śledziony – pacjenci z powiększoną śledzioną są bardziej narażeni na jej pęknięcie, nawet przy niewielkim urazie jamy brzusznej. Jest to stan zagrażający życiu wymagający natychmiastowej interwencji chirurgicznej.
Zaburzenia hematologiczne – nadmiernie aktywna śledziona może wychwytywać zbyt dużo komórek krwi, co prowadzi do cytopenii obwodowych (niedokrwistość, małopłytkowość, leukopenia).
Ucisk na okoliczne narządy – znaczne powiększenie śledziony może powodować ucisk na żołądek, lewą nerkę i naczynia krwionośne, prowadząc do dolegliwości i zaburzeń funkcjonowania tych narządów.

¹²¹³

Rokowanie po usunięciu śledziony

W przypadkach, gdy powiększenie śledziony powoduje poważne powikłania lub gdy przyczyna powiększenia nie może zostać zidentyfikowana lub leczona, może być konieczne chirurgiczne usunięcie śledziony (splenektomia).¹⁴ Większość pacjentów ma dobre rokowanie po splenektomii.¹⁵

Należy jednak pamiętać, że decyzja o usunięciu śledziony wymaga starannego rozważenia. Chociaż można prowadzić aktywne życie bez śledziony, pacjenci po splenektomii są bardziej narażeni na poważne, a nawet zagrażające życiu infekcje.¹⁶ Dlatego też w takich przypadkach konieczne jest stosowanie odpowiedniej profilaktyki przeciwinfekcyjnej, w tym szczepień ochronnych i wczesnego leczenia infekcji.

Monitorowanie i kontrola medyczna

Pacjenci z powiększoną śledzioną wymagają regularnego monitorowania i kontroli medycznej. W przypadku wykrycia splenomegalii, lekarz zazwyczaj zleca szereg badań w celu ustalenia przyczyny i monitorowania stanu pacjenta:¹⁷

Badania krwi, takie jak morfologia krwi do oceny liczby czerwonych krwinek, białych krwinek i płytek krwi w układzie oraz funkcji wątroby
Badania obrazowe (USG, TK, MRI) do oceny wielkości śledziony i wykrycia ewentualnych nieprawidłowości strukturalnych
Biopsja szpiku kostnego w przypadku podejrzenia chorób hematologicznych

¹⁸

Wnioski prognostyczne

Podsumowując, rokowanie w przypadku powiększenia śledziony zależy przede wszystkim od choroby podstawowej, a nie od samej splenomegalii.¹⁹ Chorobowość i śmiertelność w przypadkach powiększenia śledziony wynikają głównie z towarzyszących stanów chorobowych lub procedur chirurgicznych, a nie z samego powiększenia narządu.²⁰

Tymczasowe powiększenie śledziony zazwyczaj nie powoduje długotrwałych problemów zdrowotnych, podczas gdy przewlekła splenomegalia może prowadzić do uszkodzenia śledziony i zwiększać ryzyko powikłań.²¹ Wczesne rozpoznanie i leczenie choroby podstawowej jest kluczowe dla poprawy rokowania u pacjentów z powiększoną śledzioną.

W przypadku pacjentów z określonymi schorzeniami, takimi jak ostra białaczka szpikowa, objętość śledziony może służyć jako niezależny czynnik prognostyczny dla wyników leczenia po przeszczepieniu komórek macierzystych.²² Takie obserwacje mogą być pomocne w stratyfikacji ryzyka i optymalizacji protokołów leczenia.

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Splenomegaly: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/206208-overview
The prognosis for patients with splenomegaly is usually excellent and not substantially different from age-matched controls, but it is impacted by the underlying disease state rather than the presence of splenomegaly or the postsplenectomy state. […] Morbidity and mortality in cases of splenomegaly principally stem from associated disease states or surgical procedures, rather than from the splenomegaly itself. The rates for morbidity and mortality vary widely and relate to the presence or absence of comorbidities, hemorrhage, and organ failure. […] Patients with enlarged spleens are more likely to have splenic rupture from blunt abdominal or low thoracic trauma. These patients are more likely to be exposed to emergent operative splenectomy and its attendant risks.
#2 Splenomegaly: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/206208-overview
The prognosis for patients with splenomegaly is usually excellent and not substantially different from age-matched controls, but it is impacted by the underlying disease state rather than the presence of splenomegaly or the postsplenectomy state. […] Morbidity and mortality in cases of splenomegaly principally stem from associated disease states or surgical procedures, rather than from the splenomegaly itself. The rates for morbidity and mortality vary widely and relate to the presence or absence of comorbidities, hemorrhage, and organ failure. […] Patients with enlarged spleens are more likely to have splenic rupture from blunt abdominal or low thoracic trauma. These patients are more likely to be exposed to emergent operative splenectomy and its attendant risks.
#3 Enlarged Spleen (Splenomegaly): Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/17829-enlarged-spleen
An enlarged spleen is also called splenomegaly. Its a symptom of an underlying disease. […] An enlarged spleen is a symptom of many different conditions, some more serious than others. Your healthcare provider will need to investigate the underlying cause to determine if you need treatment. If an enlarged spleen goes untreated for a long time, it could eventually begin to malfunction. In rare cases, a severely enlarged spleen could rupture, which could cause internal bleeding. […] An enlarged spleen may become overactive, trapping or removing too many blood cells from circulation. This can lead to anemia, low white blood cell count or low platelet count. […] An enlarged spleen is a symptom that healthcare providers need to investigate. Whether or not its causing you discomfort, it indicates an underlying condition that may need treatment. When its temporary, an enlarged spleen wont harm your overall health. But chronic swelling could damage and endanger your spleen. Your healthcare provider will treat it by treating the underlying cause.
#4 Splenomegaly – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK430907/
Splenomegaly is defined as the enlargement of the spleen measured by size or weight. […] The prognosis for patients with splenomegaly depends on the condition causing the enlargement. Regardless of the underlying etiology, the risk of rupture, even with minor trauma, is high in patients with an enlarged spleen. […] Patients with splenomegaly from any cause are at increased risk of splenic rupture, and increased attention must be made to protect the patient from abdominal trauma. […] Most patients have a good outcome after splenectomy.
#5 Splenomegaly: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/206208-overview
The prognosis for patients with splenomegaly is usually excellent and not substantially different from age-matched controls, but it is impacted by the underlying disease state rather than the presence of splenomegaly or the postsplenectomy state. […] Morbidity and mortality in cases of splenomegaly principally stem from associated disease states or surgical procedures, rather than from the splenomegaly itself. The rates for morbidity and mortality vary widely and relate to the presence or absence of comorbidities, hemorrhage, and organ failure. […] Patients with enlarged spleens are more likely to have splenic rupture from blunt abdominal or low thoracic trauma. These patients are more likely to be exposed to emergent operative splenectomy and its attendant risks.
#6 Enlarged Spleen (Splenomegaly): Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/17829-enlarged-spleen
An enlarged spleen is also called splenomegaly. Its a symptom of an underlying disease. […] An enlarged spleen is a symptom of many different conditions, some more serious than others. Your healthcare provider will need to investigate the underlying cause to determine if you need treatment. If an enlarged spleen goes untreated for a long time, it could eventually begin to malfunction. In rare cases, a severely enlarged spleen could rupture, which could cause internal bleeding. […] An enlarged spleen may become overactive, trapping or removing too many blood cells from circulation. This can lead to anemia, low white blood cell count or low platelet count. […] An enlarged spleen is a symptom that healthcare providers need to investigate. Whether or not its causing you discomfort, it indicates an underlying condition that may need treatment. When its temporary, an enlarged spleen wont harm your overall health. But chronic swelling could damage and endanger your spleen. Your healthcare provider will treat it by treating the underlying cause.
#7 Splenomegaly: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/206208-overview
The prognosis for patients with splenomegaly is usually excellent and not substantially different from age-matched controls, but it is impacted by the underlying disease state rather than the presence of splenomegaly or the postsplenectomy state. […] Morbidity and mortality in cases of splenomegaly principally stem from associated disease states or surgical procedures, rather than from the splenomegaly itself. The rates for morbidity and mortality vary widely and relate to the presence or absence of comorbidities, hemorrhage, and organ failure. […] Patients with enlarged spleens are more likely to have splenic rupture from blunt abdominal or low thoracic trauma. These patients are more likely to be exposed to emergent operative splenectomy and its attendant risks.
#8 Enlarged Spleen (Splenomegaly): Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/17829-enlarged-spleen
An enlarged spleen is also called splenomegaly. Its a symptom of an underlying disease. […] An enlarged spleen is a symptom of many different conditions, some more serious than others. Your healthcare provider will need to investigate the underlying cause to determine if you need treatment. If an enlarged spleen goes untreated for a long time, it could eventually begin to malfunction. In rare cases, a severely enlarged spleen could rupture, which could cause internal bleeding. […] An enlarged spleen may become overactive, trapping or removing too many blood cells from circulation. This can lead to anemia, low white blood cell count or low platelet count. […] An enlarged spleen is a symptom that healthcare providers need to investigate. Whether or not its causing you discomfort, it indicates an underlying condition that may need treatment. When its temporary, an enlarged spleen wont harm your overall health. But chronic swelling could damage and endanger your spleen. Your healthcare provider will treat it by treating the underlying cause.
#9 Enlarged Spleen (Splenomegaly): Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/17829-enlarged-spleen
An enlarged spleen is also called splenomegaly. Its a symptom of an underlying disease. […] An enlarged spleen is a symptom of many different conditions, some more serious than others. Your healthcare provider will need to investigate the underlying cause to determine if you need treatment. If an enlarged spleen goes untreated for a long time, it could eventually begin to malfunction. In rare cases, a severely enlarged spleen could rupture, which could cause internal bleeding. […] An enlarged spleen may become overactive, trapping or removing too many blood cells from circulation. This can lead to anemia, low white blood cell count or low platelet count. […] An enlarged spleen is a symptom that healthcare providers need to investigate. Whether or not its causing you discomfort, it indicates an underlying condition that may need treatment. When its temporary, an enlarged spleen wont harm your overall health. But chronic swelling could damage and endanger your spleen. Your healthcare provider will treat it by treating the underlying cause.
#10
https://link.springer.com/article/10.1007/s00277-023-05353-9
Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment modality for patients with acute myeloid leukemia (AML). […] Here, we investigated the predictive value of spleen volume on outcome parameters and engraftment kinetics after HSCT in a large cohort of AML patients. […] Higher spleen volume at the time of HSCT was independently linked to adverse outcomes such as inferior OS and higher cumulative incidence of NRM in AML patients after HSCT. […] LSV was associated with inferior overall survival (OS) after HSCT (55.7% vs. 66.6% at 2 years; P=0.009) and higher cumulative incidence of NRM (28.8% vs. 20.2% at 2 years; P=0.048). […] Our data implicate that an increased spleen volume is linked to inferior outcome after allogeneic HSCT in AML patients. […] In summary, we identified spleen volume as an independent risk factor for NRM.
#11
https://link.springer.com/article/10.1007/s00277-023-05353-9
Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment modality for patients with acute myeloid leukemia (AML). […] Here, we investigated the predictive value of spleen volume on outcome parameters and engraftment kinetics after HSCT in a large cohort of AML patients. […] Higher spleen volume at the time of HSCT was independently linked to adverse outcomes such as inferior OS and higher cumulative incidence of NRM in AML patients after HSCT. […] LSV was associated with inferior overall survival (OS) after HSCT (55.7% vs. 66.6% at 2 years; P=0.009) and higher cumulative incidence of NRM (28.8% vs. 20.2% at 2 years; P=0.048). […] Our data implicate that an increased spleen volume is linked to inferior outcome after allogeneic HSCT in AML patients. […] In summary, we identified spleen volume as an independent risk factor for NRM.
#12 Enlarged Spleen (Splenomegaly): Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/17829-enlarged-spleen
An enlarged spleen is also called splenomegaly. Its a symptom of an underlying disease. […] An enlarged spleen is a symptom of many different conditions, some more serious than others. Your healthcare provider will need to investigate the underlying cause to determine if you need treatment. If an enlarged spleen goes untreated for a long time, it could eventually begin to malfunction. In rare cases, a severely enlarged spleen could rupture, which could cause internal bleeding. […] An enlarged spleen may become overactive, trapping or removing too many blood cells from circulation. This can lead to anemia, low white blood cell count or low platelet count. […] An enlarged spleen is a symptom that healthcare providers need to investigate. Whether or not its causing you discomfort, it indicates an underlying condition that may need treatment. When its temporary, an enlarged spleen wont harm your overall health. But chronic swelling could damage and endanger your spleen. Your healthcare provider will treat it by treating the underlying cause.
#13 Splenomegaly – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK430907/
Splenomegaly is defined as the enlargement of the spleen measured by size or weight. […] The prognosis for patients with splenomegaly depends on the condition causing the enlargement. Regardless of the underlying etiology, the risk of rupture, even with minor trauma, is high in patients with an enlarged spleen. […] Patients with splenomegaly from any cause are at increased risk of splenic rupture, and increased attention must be made to protect the patient from abdominal trauma. […] Most patients have a good outcome after splenectomy.
#14 Enlarged spleen (splenomegaly) – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/enlarged-spleen/diagnosis-treatment/drc-20354331
An enlarged spleen is usually detected during a physical exam. Your doctor might order these tests to confirm the diagnosis of an enlarged spleen: Blood tests, such as a complete blood count to check the number of red blood cells, white blood cells and platelets in your system and liver function […] Your doctor might recommend surgery to remove your spleen (splenectomy) for diagnostic purposes when there’s no identifiable cause for the enlargement. More often, the spleen is removed as treatment. After surgery to remove it, the spleen is examined under a microscope to check for possible lymphoma of the spleen. […] If an enlarged spleen causes serious complications or the cause can’t be identified or treated, surgery to remove your spleen (splenectomy) might be an option. In chronic or critical cases, surgery might offer the best hope for recovery. […] Elective spleen removal requires careful consideration. You can live an active life without a spleen, but you’re more likely to get serious or even life-threatening infections after spleen removal.
#15 Splenomegaly – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK430907/
Splenomegaly is defined as the enlargement of the spleen measured by size or weight. […] The prognosis for patients with splenomegaly depends on the condition causing the enlargement. Regardless of the underlying etiology, the risk of rupture, even with minor trauma, is high in patients with an enlarged spleen. […] Patients with splenomegaly from any cause are at increased risk of splenic rupture, and increased attention must be made to protect the patient from abdominal trauma. […] Most patients have a good outcome after splenectomy.
#16 Enlarged spleen (splenomegaly) – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/enlarged-spleen/diagnosis-treatment/drc-20354331
An enlarged spleen is usually detected during a physical exam. Your doctor might order these tests to confirm the diagnosis of an enlarged spleen: Blood tests, such as a complete blood count to check the number of red blood cells, white blood cells and platelets in your system and liver function […] Your doctor might recommend surgery to remove your spleen (splenectomy) for diagnostic purposes when there’s no identifiable cause for the enlargement. More often, the spleen is removed as treatment. After surgery to remove it, the spleen is examined under a microscope to check for possible lymphoma of the spleen. […] If an enlarged spleen causes serious complications or the cause can’t be identified or treated, surgery to remove your spleen (splenectomy) might be an option. In chronic or critical cases, surgery might offer the best hope for recovery. […] Elective spleen removal requires careful consideration. You can live an active life without a spleen, but you’re more likely to get serious or even life-threatening infections after spleen removal.
#17 Enlarged spleen (splenomegaly) – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/enlarged-spleen/diagnosis-treatment/drc-20354331
An enlarged spleen is usually detected during a physical exam. Your doctor might order these tests to confirm the diagnosis of an enlarged spleen: Blood tests, such as a complete blood count to check the number of red blood cells, white blood cells and platelets in your system and liver function […] Your doctor might recommend surgery to remove your spleen (splenectomy) for diagnostic purposes when there’s no identifiable cause for the enlargement. More often, the spleen is removed as treatment. After surgery to remove it, the spleen is examined under a microscope to check for possible lymphoma of the spleen. […] If an enlarged spleen causes serious complications or the cause can’t be identified or treated, surgery to remove your spleen (splenectomy) might be an option. In chronic or critical cases, surgery might offer the best hope for recovery. […] Elective spleen removal requires careful consideration. You can live an active life without a spleen, but you’re more likely to get serious or even life-threatening infections after spleen removal.
#18 Enlarged spleen (splenomegaly) – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/enlarged-spleen/diagnosis-treatment/drc-20354331
An enlarged spleen is usually detected during a physical exam. Your doctor might order these tests to confirm the diagnosis of an enlarged spleen: Blood tests, such as a complete blood count to check the number of red blood cells, white blood cells and platelets in your system and liver function […] Your doctor might recommend surgery to remove your spleen (splenectomy) for diagnostic purposes when there’s no identifiable cause for the enlargement. More often, the spleen is removed as treatment. After surgery to remove it, the spleen is examined under a microscope to check for possible lymphoma of the spleen. […] If an enlarged spleen causes serious complications or the cause can’t be identified or treated, surgery to remove your spleen (splenectomy) might be an option. In chronic or critical cases, surgery might offer the best hope for recovery. […] Elective spleen removal requires careful consideration. You can live an active life without a spleen, but you’re more likely to get serious or even life-threatening infections after spleen removal.
#19 Splenomegaly: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/206208-overview
The prognosis for patients with splenomegaly is usually excellent and not substantially different from age-matched controls, but it is impacted by the underlying disease state rather than the presence of splenomegaly or the postsplenectomy state. […] Morbidity and mortality in cases of splenomegaly principally stem from associated disease states or surgical procedures, rather than from the splenomegaly itself. The rates for morbidity and mortality vary widely and relate to the presence or absence of comorbidities, hemorrhage, and organ failure. […] Patients with enlarged spleens are more likely to have splenic rupture from blunt abdominal or low thoracic trauma. These patients are more likely to be exposed to emergent operative splenectomy and its attendant risks.
#20 Splenomegaly: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/206208-overview
The prognosis for patients with splenomegaly is usually excellent and not substantially different from age-matched controls, but it is impacted by the underlying disease state rather than the presence of splenomegaly or the postsplenectomy state. […] Morbidity and mortality in cases of splenomegaly principally stem from associated disease states or surgical procedures, rather than from the splenomegaly itself. The rates for morbidity and mortality vary widely and relate to the presence or absence of comorbidities, hemorrhage, and organ failure. […] Patients with enlarged spleens are more likely to have splenic rupture from blunt abdominal or low thoracic trauma. These patients are more likely to be exposed to emergent operative splenectomy and its attendant risks.
#21 Enlarged Spleen (Splenomegaly): Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/17829-enlarged-spleen
An enlarged spleen is also called splenomegaly. Its a symptom of an underlying disease. […] An enlarged spleen is a symptom of many different conditions, some more serious than others. Your healthcare provider will need to investigate the underlying cause to determine if you need treatment. If an enlarged spleen goes untreated for a long time, it could eventually begin to malfunction. In rare cases, a severely enlarged spleen could rupture, which could cause internal bleeding. […] An enlarged spleen may become overactive, trapping or removing too many blood cells from circulation. This can lead to anemia, low white blood cell count or low platelet count. […] An enlarged spleen is a symptom that healthcare providers need to investigate. Whether or not its causing you discomfort, it indicates an underlying condition that may need treatment. When its temporary, an enlarged spleen wont harm your overall health. But chronic swelling could damage and endanger your spleen. Your healthcare provider will treat it by treating the underlying cause.
#22
https://link.springer.com/article/10.1007/s00277-023-05353-9
Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment modality for patients with acute myeloid leukemia (AML). […] Here, we investigated the predictive value of spleen volume on outcome parameters and engraftment kinetics after HSCT in a large cohort of AML patients. […] Higher spleen volume at the time of HSCT was independently linked to adverse outcomes such as inferior OS and higher cumulative incidence of NRM in AML patients after HSCT. […] LSV was associated with inferior overall survival (OS) after HSCT (55.7% vs. 66.6% at 2 years; P=0.009) and higher cumulative incidence of NRM (28.8% vs. 20.2% at 2 years; P=0.048). […] Our data implicate that an increased spleen volume is linked to inferior outcome after allogeneic HSCT in AML patients. […] In summary, we identified spleen volume as an independent risk factor for NRM.