A Case of Hereditary Spherocytosis in a Patient who Received Chemotherapy Safely after Splenectomy

Abstract

A 57-year-old female with hereditary spherocytosis (HS) presenting a mass in her left breast was referred to our hospital. She was diagnosed with left breast cancer cT2N0M0 cStage IIA. She underwent partial mastectomy and sentinel lymph node biopsy. One lymph node was positive for metastasis, and axillary lymph node dissection was performed. Pathological investigation revealed pT2N1M0 pStage IIB cancer. Radiation therapy, hormonal therapy, and adjuvant chemotherapy were scheduled.

After the first dose of chemotherapy, she was admitted to our hospital due to anemia and jaundice caused by the chemotherapy-induced hemolytic crisis ; hence, chemotherapy was canceled.

Computed tomography (CT) revealed multiple metastases of the spleen and the liver after 2 years post-operation. Splenectomy with partial hepatectomy was performed because of the possibility of using chemotherapy again. After several courses of hormonal therapy, the metastatic lesions continued to grow. Chemotherapy was re-challenged, and no hemolysis was observed because of splenectomy. Thus, she could continue with her treatment.

We suggest that splenectomy can enable patients with HS to undergo chemotherapy safely.