title: [Acute myelogenous leukemia with multilineage myelodysplasia, positive direct Coombs test, and elevated levels of platelet-associated IgG].
abstract: 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.
authors.affiliation: Department of Internal Medicine, Higashi Sapporo Hospital.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuroda
authors.forename: Takuya
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Sumio
authors.initials: S
authors.lastname: Sakamaki
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.forename: Takeshi
authors.initials: T
authors.lastname: Terui
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Neda
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Ishitani
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nobuoka
authors.forename: Masaya
authors.initials: M
authors.lastname: Kida
authors.forename: Hideki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Niitsu
mesh_terms: D015250:Aclarubicin / Q000008:administration & dosage; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001792:Blood Platelets / Q000276:immunology*; D003298:Coombs Test; D003561:Cytarabine / Q000008:administration & dosage; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D010198:Pancytopenia / Q000209:etiology; D011239:Prednisolone / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D007074:Immunoglobulin G; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D015250:Aclarubicin; D011239:Prednisolone