Autoimmune hemolytic anemia may be accompanied in a wide variety of diseases, but it is far more rarely encountered in the myelogenous leukemia.
A 77-year-old male with acute myelogenous leukemia, when he was in the partial remission, was admitted because of exacerbation of the anemia.
On admission, his hemoglobin level was 5.1 gm/100 ml, reticulocytes 42‰, the platelet count 54,000/mm3 and leukocyte count 2450/mm3 with 1% myeloblasts. Bone marrow smear revealed 15% myeloblasts and hyperplasia of erythroid elements. The erythrocyte life span (T 1/2) as measured by 51Cr was reduced. (8 days). The serum indirect bilirubin was 0.8 mg/100 ml, Type I of LDH isozyme increased and haptoglobin undetectable. The direct Coombs test was strongly positive and the autoantibodies to the erythrocytes were found to be IgG (κ).
After initiation of treatment with prednisolone, the direct Coombs test became negative and anemia gradually alleviated.
These findings strongly suggested that autoimmune hemolytic anemia had occurred in the course of acute myelogenous leukemia.
