一名 53 岁男性患有急性髓性白血病，接受了来自匹配的无关捐赠者的同种异体造血细胞移植 (HCT)。移植后一个月，他出现 ARDS，需要启动 VV-ECMO。他患有全血细胞减少症，通过频繁输血、粒细胞集落刺激因子 (G-CSF) 和每周一次血小板生成素受体激动剂进行治疗。 ECMO 第 17 天，患者因右侧大量气胸插入胸管后出现严重低血压。腹部CT血管造影显示腹腔积血。剖腹探查发现大约 4 升血液和破裂的脾门。进行了脾切除术。不幸的是，患者仍需要每日多次血液制品，尽管进行了两次手术，但他的病情继续恶化。他的家人选择终止ECMO，他平静地去世了。接受 VV-ECMO 治疗的患者中从未有过 GM-CSF 后自发性脾破裂的报道。本手稿回顾了有关这种罕见情况的病理生理学和临床表现的文献。版权所有 © 2024。由 Elsevier Inc. 出版。

A 53-year-old man with acute myeloid leukemia received an allogeneic hematopoietic cell transplant (HCT) from a matched unrelated donor. One month after his transplantation, he developed ARDS requiring initiation of VV-ECMO. He suffered from pancytopenia, managed with frequent transfusions, granulocyte-colony stimulating factor (G-CSF) and weekly thrombopoietin receptor agonist. On ECMO day 17, the patient developed severe hypotension after insertion of a chest tube for a large right-sided pneumothorax. CT angiography of the abdomen showed hemoperitoneum. Exploratory laparotomy revealed approximately 4 L of blood and a ruptured splenic hilum. A splenectomy was performed. Unfortunately, the patient continued to require multiple daily blood products and his condition continued to decline despite two reoperations. His family chose to discontinue ECMO and he passed away peacefully. Spontaneous splenic rupture after GM-CSF has never been reported in patients on VV-ECMO. This manuscript reviews the literature regarding the pathophysiology and clinical manifestation of this rare occurrence.Copyright © 2024. Published by Elsevier Inc.