Abstract
A 47-year-old woman (MC) with severe anemia and red cell aplasia was found to have a serum monoclonal immunoglobulin component (M-component) but no evidence of overt multiple myeloma. The patient was treated with cyclophosphamide and prednisone, resulting in normalization of red cell values and a 75% reduction in the level of serum M-component. A colony-growth assay demonstrated specific inhibition of normal burst-forming unit-erythroid formation in the presence of a concentration of the patient's purified immunoglobulin, which approximated 60% of its plasma level at presentation. Burst-forming unit-erythroid colony-growth inhibition was not seen with the addition of similar concentrations of normal pooled immunoglobulin or another monoclonal immunoglobulin from a myeloma patient (DK). These results suggest that the monoclonal immunoglobulin from patient MC was an antibody to erythroid precursor cells.
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