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Malignant osteopetrosis: hypercalcaemia after bone marrow transplantation.
P S Rawlinson1, R H Green, A M Coggins
1Department of Haematology, Royal Infirmary, Glasgow.
Archives of Disease in Childhood
|May 1, 1991
Summary
Malignant osteopetrosis in a child was treated with bone marrow transplant. Hypercalcemia post-transplant was managed with bisphosphonates, phosphate, fluids, and calcitonin, leading to a successful outcome.
Area of Science:
- Pediatric Hematology
- Pediatric Oncology
- Genetics
Background:
- Malignant osteopetrosis is a rare genetic disorder characterized by impaired osteoclast function, leading to bone sclerosis.
- Allogeneic bone marrow transplantation (BMT) is a potential curative treatment for malignant osteopetrosis.
- Hypercalcemia is a known complication following BMT.
Observation:
- A 3-year-old girl with malignant osteopetrosis underwent allogeneic BMT.
- Post-transplant, the patient experienced prolonged hypercalcemia.
- The hypercalcemia was managed using a multi-modal approach.
Findings:
- Successful engraftment was achieved after BMT.
- The combination of bisphosphonate, phosphate infusions, vigorous fluid resuscitation, and salmon calcitonin effectively controlled hypercalcemia.
- The patient remained alive and well 16 months post-transplant.
Implications:
- This case highlights the successful management of severe hypercalcemia following BMT in a pediatric patient with malignant osteopetrosis.
- The therapeutic strategy employed offers a potential approach for managing similar post-transplant complications.
- Long-term follow-up is crucial for assessing the sustained efficacy of BMT and management of complications.