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Hypercalcemia in children presenting with acute lymphoblastic leukemia
S Hibi1, H Funaki, R Ochiai-Kanai
1Department of Pediatrics, Kyoto Prefectural University of Medicine, Japan.
International Journal of Hematology
|December 24, 1997
Summary
Hypercalcemia, a complication of malignant disorders, was studied in pediatric acute lymphoblastic leukemia (ALL). High parathormone related peptide (PTHrP) levels were observed in 4.8% of patients, presenting with GI and skeletal symptoms, but did not impact prognosis.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Hematology
Background:
- Hypercalcemia is a known complication in malignancies.
- The incidence, prognostic significance, and role of parathormone related peptide (PTHrP) in pediatric acute lymphoblastic leukemia (ALL) remain unclear.
Purpose of the Study:
- To clarify the incidence and prognostic significance of hypercalcemia in pediatric ALL.
- To investigate the role of PTHrP in pediatric ALL with hypercalcemia.
Main Methods:
- Retrospective analysis of 83 newly diagnosed pediatric ALL patients with early pre-B cell phenotype.
- Measurement of serum calcium and PTHrP levels at diagnosis.
- Clinical assessment of symptoms and treatment outcomes.
Main Results:
- Four patients (4.8%) were diagnosed with hypercalcemia (> 14 mg/dl) at onset.
- Hypercalcemic patients exhibited markedly elevated PTHrP levels (112-240 pmol/l).
- Characteristic initial symptoms included gastrointestinal and skeletal complaints; hypercalcemia resolved with chemotherapy, and all patients achieved complete remission.
Conclusions:
- Hypercalcemia occurs in approximately 4.8% of pediatric ALL patients with early pre-B cell phenotype.
- Elevated PTHrP is associated with hypercalcemia in these patients.
- Gastrointestinal and skeletal symptoms are characteristic initial presentations, and hypercalcemia does not appear to significantly affect prognosis.