A 60-year-old woman complained of general malaise and visited our hospital in August, 1984. Blood examinations revealed Hb 9.0 g/dl, RBC 287×104/mm3, WBC 2100/mm3, thrombocyte 12.3×104/mm3 and reticulocytes 7.8%. Many poikilocytes especially elliptocytes were seen in a smear of the peripheral blood. Liver function tests showed billirubin of 1.6 mg/dl (indirect bil. 1.1 mg/dl) and LDH of 524 W-U. Serum immunoelectrophoresis disclosed M-protein (IgG-κ type). But she admitted other hospital and splenectomy was performed under the diagnosis of Banti syndrome. Anemia was not improved, so she was referred again to our hospital. From bone marrow and peripheral smear, diagnosis of acute leukemia in elliptocytosis with M-proteinemia was made. So combination chemotherapy was carried out but remission was not obtained. And she died of pneumonia.
