Acute myelogenous leukemia with multilineage myelodysplasia, positive direct Coombs test, and elevated levels of platelet-associated IgG

• Published in: Rinshō ketsueki Vol. 48; no. 5; p. 407
• Main Authors: Kuroda, Hiroyuki, Matsunaga, Takuya, Sakamaki, Sumio, Koike, Kazuhiko, Terui, Takeshi, Neda, Hiroshi, Ishitani, Kunihiko, Nobuoka, Atsushi, Kida, Masaya, Watanabe, Hideki, Niitsu, Yoshiro
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.05.2007
• Subjects: Aclarubicin - administration & dosage; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Blood Platelets - immunology; Coombs Test; Cytarabine - administration & dosage; Granulocyte Colony-Stimulating Factor - administration & dosage; Humans; Immunoglobulin G - blood; Leukemia, Myeloid, Acute - blood; Leukemia, Myeloid, Acute - complications; Leukemia, Myeloid, Acute - diagnosis; Leukemia, Myeloid, Acute - drug therapy; Male; Myelodysplastic Syndromes - blood; Myelodysplastic Syndromes - complications; Myelodysplastic Syndromes - diagnosis; Myelodysplastic Syndromes - drug therapy; Pancytopenia - etiology; Prednisolone - administration & dosage; Treatment Outcome
• ISSN: 0485-1439
• DOI: 10.11406/rinketsu.48.407

A 75-year-old man was admitted to our hospital in October, 2005 for examination of pre-diagnosed pancytopenia. His bone marrow showed myeloid dysplasia, and 30.4% of the nucleated cells were blasts. Our diagnosis was acute myelogenous leukemia with multilineage myelodysplasia (AML with MLD; WHO classification). A direct Coombs test proved positive, and the platelet-associated IgG (PA-IgG) level was elevated. After treatment with CAG (Ara-C + ACR + G-CSF), complete remission was obtained, showing negative on the direct Coombs test with PA-IgG levels returned to normal. The patient subsequently relapsed, testing positive on the direct Coombs test and experiencing a re-elevation of PA-IgG levels. We report here a first case of AML with MLD, direct Coombs test and PA-IgG assay.