ACUTE MEGAKARYOCYTIC LEUKEMIA IN A PATIENT WITH MULTIPLE MYELOMA

Abstract

A 69 year-old man who had been treated for multiple myeloma with intermittent melphalan for 3 years was admitted because of fever, hepatomegaly, and pancytopenia. Abundant blastic cells appeared later in his blood while serum IgG and Bence-Jones proteinuria did not increase. The peroxidase and gene rearrangement of immunoglobulin J (H) was negative on blastic cells, but CD41 was positive. Some of blastic cells showed platelet-peroxidase by electron microscopic examination. Generalized infiltration of blastic cells was observed in autopsy and, factor VIII related antigen was stained immunohistochemically. He was diagnosed as having acute megakaryocytic leukemia following multiple myeloma.