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Oral cyclophosphamide was effective for Coombs-negative autoimmune hemolytic anemia in CD16+CD56− chronic lymphoproliferative disorder of NK-cells

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Abstract

An 84-year-old woman was referred to our hospital presenting anemia. Her hemoglobin level was 5.8 g/dL, and white blood cell count was 9400/μL, consisting of 82% lymphocytes. Given the lymphocyte phenotype (CD2+, CD3−, CD16+, and CD56−) and negative whole blood EBV viral load, we made a diagnosis of chronic lymphoproliferative disorder of NK cells (CLPD-NK). We suspected hemolytic anemia because of the high levels of reticulocytes in the peripheral blood and the low haptoglobin value. Although the direct Coombs test was negative and there was no cold agglutination, we examined her red-blood-cell-bound IgG (RBC-IgG), which was elevated. She was diagnosed as having as Coombs-negative autoimmune hemolytic anemia (AIHA). We report the effectiveness of oral cyclophosphamide for Coombs-negative autoimmune hemolytic anemia in CLPD-NK.

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Acknowledgement

The authors would like to thank Dr. Toyomi Kamesaki at Jichi Medical School for the analysis of RBC-bound IgG.

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Authors and Affiliations

  1. Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan

    Nodoka Sekiguchi & Tomonobu Koizumi

  2. Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan

    Nodoka Sekiguchi, Sayaka Nishina, Toru Kawakami, Hitoshi Sakai, Noriko Senoo, Yasushi Senoo, Hideyuki Nakazawa & Fumihiro Ishida

  3. Division of Hematology, Matsumoto Medical Center Masumoto Hospital, Matsumoto, Nagano, Japan

    Toshiro Ito

  4. Department of Internal Medicine, Nagano Prefectural Suzaka Hospital, Suzaka, Nagano, Japan

    Hiroshi Saito

  5. Department of Biomedical Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan

    Fumihiro Ishida

Authors
  1. Nodoka Sekiguchi
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  2. Sayaka Nishina
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  3. Toru Kawakami
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  4. Hitoshi Sakai
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  5. Noriko Senoo
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  6. Yasushi Senoo
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  7. Toshiro Ito
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  9. Hideyuki Nakazawa
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  10. Tomonobu Koizumi
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  11. Fumihiro Ishida
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Correspondence to Nodoka Sekiguchi.

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Sekiguchi, N., Nishina, S., Kawakami, T. et al. Oral cyclophosphamide was effective for Coombs-negative autoimmune hemolytic anemia in CD16+CD56− chronic lymphoproliferative disorder of NK-cells. Int J Hematol 105, 854–858 (2017). https://doi.org/10.1007/s12185-016-2170-4

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  • DOI: https://doi.org/10.1007/s12185-016-2170-4

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