{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:47:52Z","timestamp":1777420072175,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2013,4,11]],"date-time":"2013-04-11T00:00:00Z","timestamp":1365638400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To report the development of a spontaneous subcapsular splenic hematoma following filgrastim administration in a patient undergoing an allogeneic hematopoietic stem cell transplant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE SUMMARY<\/jats:title>\n                    <jats:p>A 60-year-old female with myelodysplastic syndrome was admitted for a reduced-intensity allogeneic hematopoietic stem cell transplant from an unrelated donor. She received filgrastim 5 \u03bcg\/kg starting on day 1 to accelerate neutrophil recovery. On day 5, she began reporting severe left chest-wall pain. Contrast-enhanced computed tomography of the abdomen\/pelvis revealed a spontaneous subcapsular splenic hematoma. Upon discontinuation of filgrastim, the pain fully resolved. The patient was subsequently rechallenged with filgrastim, which led to recurrence of the left-sided chest-wall pain. Filgrastim was discontinued and the patient reported resolution of the pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Filgrastim has been associated with splenic hematoma and splenic rupture, predominantly in healthy donors undergoing mobilization of peripheral blood stem cells. Although splenic rupture attributed to filgrastim in a patient undergoing allogeneic hematopoietic stem cell transplantation has been reported, to our knowledge, this is the first case report to establish causality. Using the Naranjo probability scale, an objective causality assessment revealed that the adverse drug event was highly probable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Although filgrastim-induced splenomegaly, splenic hematomas, and splenic rupture are rare, clinicians working in the bone marrow transplant setting should be cognizant of the potential of growth factors to cause these adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1s005","type":"journal-article","created":{"date-parts":[[2013,4,12]],"date-time":"2013-04-12T23:41:59Z","timestamp":1365810119000},"page":"e22-e22","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Spontaneous Subcapsular Splenic Hematoma Associated with Filgrastim in a Patient Undergoing Allogeneic Hematopoietic Stem Cell Transplantation"],"prefix":"10.1177","volume":"47","author":[{"given":"Alex","family":"Ganetsky","sequence":"first","affiliation":[{"name":"Alex Ganetsky PharmD BCOP, Hematology\/Oncology Clinical Pharmacy Specialist, Pharmacy Department, Hospital of the University of Pennsylvania, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colleen","family":"Kucharczuk","sequence":"additional","affiliation":[{"name":"Colleen Kucharczuk MSN CRNP, Nurse Practitioner, Division of Hematology\/Oncology, Hospital of the University of Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Del","family":"Percio","sequence":"additional","affiliation":[{"name":"Sarah Del Percio MSN CRNP, Nurse Practitioner, Division of Hematology\/Oncology, Hospital of the University of Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noelle","family":"Frey","sequence":"additional","affiliation":[{"name":"Noelle Frey MD MS, Assistant Professor of Medicine, Division of Hematology\/Oncology, Hospital of the University of Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saar","family":"Gill","sequence":"additional","affiliation":[{"name":"Saar Gill MBBS PhD FRACP, Clinical Instructor, Division of Hematology\/Oncology, Hospital of the University of Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,4,11]]},"reference":[{"key":"bibr1-aph.1S005","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra052638"},{"key":"bibr2-aph.1S005","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2010.01.010"},{"key":"bibr3-aph.1S005","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V96.1.80"},{"key":"bibr4-aph.1S005","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199207023270106"},{"key":"bibr5-aph.1S005","volume-title":"Package insert. 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