Immunological Abnormalities in Myelodysplastic Syndromes

—Three Cases with Positive Direct Coombs' Test—

Abstract

Immunological abnormalities have been reported in myelodysplastic syndromes (MDS), but little is known about the incidence of positive direct Coombs' test in MDS. The immunoglobulin levels and autoantibody profiles of 29 patients with primary MDS, classified according to the FAB criteria, were analysed. Of the 29 patients, 11 patients (37.9%) showed a polyclonal rise in serum immunoglobulins and four patients (13.8%) had low immunoglobulin levels. Out of 23 patients tested, the direct Coombs' test was positive in three (13.0%). Of these three patients, a polyclonal rise in serum immunoglobulins was present in two, rheumatoid factor in one, and anti-DNA antibody in two. Two of these patients had autoimmune hemolytic anemia. We report these patients with positive direct Coombs' test in MDS, and also discuss a correlation between immunological abnormalities and their clinical course.