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2007Kuroda Hiroyuki; Matsunaga Takuya; Sakamaki Sumio; Koike Kazuhiko; Terui Takeshi; Neda Hiroshi; Ishitani Kunihiko; Nobuoka Atsushi; Kida Masaya; Watanabe Hideki; Niitsu Yoshiro
[Acute myelogenous leukemia with multilineage myelodysplasia, positive direct Coombs test, and elevated levels of platelet-associated IgG]
[Rinsho ketsueki] The Japanese journal of clinical hematology 2007;48(5):407-11.
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.

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