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Acute Lymphoblastic Leukemia with Malignant Hypercalcemia: A Case Report
Mădălina Bota1, Gheorghe Popa1, Alexandra Neaga1
1Department of Pediatrics, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
The American Journal of Case Reports
|March 29, 2019
Summary
Malignant hypercalcemia in pediatric leukemia is rare and associated with a poor prognosis. Aggressive treatment strategies may be necessary for better outcomes in these challenging cases.
Area of Science:
- Pediatric Hematology
- Oncology
- Endocrinology
Background:
- Malignant hypercalcemia is uncommon in children, particularly with hematological malignancies like leukemia.
- This case highlights the challenges of managing hypercalcemia secondary to acute lymphoblastic leukemia in a pediatric patient.
Observation:
- A 6-year-old female with acute lymphoblastic leukemia developed secondary malignant hypercalcemia.
- The patient experienced relapse with hypercalcemia, requiring multiple treatment modalities including chemotherapy, calcitonin, bisphosphonates, and supportive care.
- Complications included severe osteolysis, bone fractures, superinfected bedsores, and ultimately, severe sepsis with multiple organ failure.
Findings:
- Initial chemotherapy achieved remission, but relapse occurred with recurrent hypercalcemia.
- Treatment for hypercalcemia involved calcitonin, bisphosphonates (zoledronic acid, clodronate), and hydration.
- Despite interventions, the leukemia progressed, and the patient succumbed to complications including sepsis.
Implications:
- Malignant hypercalcemia in pediatric leukemia indicates a poor prognosis.
- Management requires aggressive and potentially novel therapeutic approaches.
- Further research into effective treatments for this rare complication is warranted.
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