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Title of Journal: Int J Hematol

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Abbravation: International Journal of Hematology

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Springer Japan

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DOI

10.1007/bfb0116777

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1865-3774

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Major surgery in a neutropenic patient undergoing

Authors: Petter Brodin Stefan Gilg Lars Lundell Jonas Mattsson
Publish Date: 2012/09/29
Volume: 96, Issue: 6, Pages: 798-800
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Abstract

Certain homeostatic functions are particularly important to the success of extensive surgery For example metabolic homeostasis inflammation and tissue repair coagulation and immune defense against infection are all of great importance In patients undergoing allogeneic hematopoietic stem cell transplantation ASCT the ability to mount adequate inflammatory responses is severely impaired Thrombocytopenia is common making coagulation inadequate for any kind of invasive procedure let alone extensive surgery For this reason abdominal surgery in neutropenic patients is associated with very high mortality rates of between 50 and 70  1 Here we describe a patient with highrisk myelofibrosis who required extensive abdominal surgery during the aplastic phase only 7 days after ASCT due to severe abdominal hemorrhage This patient’s successful recovery shows that extensive surgery is possible even during the aplastic phase after ASCT Interestingly we also found that radical splenectomy 7 days after stem cell transplantation did not lead to any significant loss of infused stem cells

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