Pathologic rupture of the spleen during induction with ATRA in a patient with acute promyelocytic leukemia

Pathological rupture of the spleen is a rare but well recognized complicati on in hematological malignancies. Early clinical recognition of this life-t hreatening complication is necessary for rapid intervention. Here, we repor t on the case of a 26-year-old woman with acute promyelocytic leukemia who presented rupture of the spleen on day +2 of treatment with ATRA plus idarr ubicin. In patients with acute leukemia, the presence of a painful abdomen and a sudden drop in hemoglobin levels, should alert of a possible splenic rupture, even without additional symptoms. This would facilitate an early t reatment intervention with no modification to the chemotherapy schedule.