Benign transient hyperphosphatasemia in children with leukemia and lymphoma

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G V Massey1, N L Dunn, J L Heckel

  • 1Department of Pediatrics, Children's Medical Center, Virginia Commonwealth University, Richmond 23298-0121, USA.

Clinical Pediatrics
|October 1, 1996
PubMed

Insights

Benign hyperphosphatasemia, a temporary rise in alkaline phosphatase, can occur in children during cancer therapy. This condition resolved without changing chemotherapy, indicating it is not linked to liver damage.

Area of Science:

  • Pediatric Oncology
  • Biochemistry

Background:

  • Benign hyperphosphatasemia is a transient elevation of serum alkaline phosphatase (ALP) in young children without liver or bone disease.
  • This phenomenon is rare and typically resolves spontaneously.

Observation:

  • The study observed three children with acute lymphoblastic leukemia and lymphoma experiencing benign hyperphosphatasemia during chemotherapy.
  • These children were in remission and receiving methotrexate, 6-mercaptopurine, and sulfamethoxazole/trimethoprim.

Findings:

  • Despite chemotherapy, liver transaminases (ALT, AST) remained normal.
  • The elevation was specific to the bone isoenzyme of alkaline phosphatase, ruling out hepatic toxicity.
  • The condition resolved without any modification to the chemotherapy regimen.

Implications:

  • Benign hyperphosphatasemia is a possible, albeit rare, side effect in pediatric cancer patients undergoing specific chemotherapy regimens.
  • Monitoring alkaline phosphatase isoenzymes can help differentiate this benign condition from drug-induced liver injury.
  • This finding reassures clinicians that this transient elevation does not necessitate treatment interruption.

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