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Parathyroid-hormone-related peptide in hematologic malignancies
1Department of Medicine, Royal Victoria Hospital, Montreal, Quebec, Canada.
The American Journal of Medicine
|April 1, 1996
Summary
Parathyroid-hormone-related peptide (PTHRP) is a key factor in hypercalcemia for hematologic malignancies, especially non-Hodgkin's lymphoma. Elevated PTHRP levels correlate with advanced disease and respond to treatment.
Area of Science:
- Endocrinology
- Oncology
- Hematology
Background:
- Hypercalcemia is a common complication of hematologic malignancies.
- The role of parathyroid-hormone-related peptide (PTHRP) in this context requires further elucidation.
Purpose of the Study:
- To investigate PTHRP as a potential mediator of hypercalcemia in patients with hematologic malignancies.
- To assess the correlation between PTHRP levels and specific hematologic cancer types and stages.
Main Methods:
- A cohort study involving 76 patients with hematologic malignancies (NHL, Hodgkin's disease, myeloma, Waldenstrom's) and 30 controls.
- Measurement of circulating PTHRP concentrations using NH2-terminal radioimmunoassay.
Main Results:
- Hypercalcemic patients, particularly those with non-Hodgkin's lymphoma (NHL), showed significantly elevated PTHRP levels (P <0.01).
- Elevated PTHRP was more prevalent in advanced-stage (IV) and high-grade NHL.
- PTHRP levels decreased with tumor response to chemotherapy in NHL patients.
- Suppression of 1,25(OH)2D3 was observed in 66% of hypercalcemic NHL patients.
Conclusions:
- PTHRP is implicated as a significant pathogenetic factor in hypercalcemia associated with hematologic malignancies.
- Non-Hodgkin's lymphoma is a notable malignancy where PTHRP plays a critical role in hypercalcemia development.