2005
DOI: 10.1002/pbc.20357
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Acute lymphocytic leukemia in adolescence with multiple osteolytic lesions and hypercalcemia mediated by lymphoblast‐producing parathyroid hormone‐related peptide: A case report and review of the literature

Abstract: The present case suggests that blast-producing PTHrP might be associated with multiple osteolytic lesions and hypercalcemia. PTHrP expressed in the lymphoblasts may, in itself, confer a survival advantage to lymphoblasts and contribute to the refractory nature of the disease.

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Cited by 48 publications
(33 citation statements)
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“…However, as there was no difference in the final outcome of survival or renal insufficiency between the patients treated with and without bisphosphonate, the usefulness of bisphosphonate in treating hypercalcemia that develops in ALL patients must be confirmed in a future large prospective study. Table 5 summarizes the characteristics of 12 previously reported cases of t(17;19)-ALL [9][10][11][14][15][16]34,35 in addition to five cases identified in the present study. Hypercalcemia developed in 10 of 14 cases: four patients at their original diagnosis and six patients at disease recurrence.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…However, as there was no difference in the final outcome of survival or renal insufficiency between the patients treated with and without bisphosphonate, the usefulness of bisphosphonate in treating hypercalcemia that develops in ALL patients must be confirmed in a future large prospective study. Table 5 summarizes the characteristics of 12 previously reported cases of t(17;19)-ALL [9][10][11][14][15][16]34,35 in addition to five cases identified in the present study. Hypercalcemia developed in 10 of 14 cases: four patients at their original diagnosis and six patients at disease recurrence.…”
Section: Discussionmentioning
confidence: 99%
“…1,3,4 Hypercalcemia in malignancy is frequently mediated with parathyroid hormone-related peptide (PTHrP) by increasing osteoclastic bone resorption, renal resorption of calcium and renal phosphate loss. 5,6 Although several case reports showed the involvement of PTHrP in childhood ALL complicated with hypercalcemia, [7][8][9] its significance remains to be confirmed in a larger study. t(17;19)(q21-q22;p13), which generates E2A-HLF fusion transcription factor, 10,11 is a rare translocation present in less than 1% of childhood ALL cases, 12 and its association with hypercalcemia, acquired coagulation abnormalities and extremely poor therapeutic outcome has been noticed.…”
Section: Introductionmentioning
confidence: 99%
“…Reverse transcriptase-polymerase chain reaction and immuno histochemistry showed in one study that lymphoblasts produced PTHrP directly [6]. Multiple osteolytic lesions with necrosis of bone marrow has also been reported in pediatric patients [7].…”
Section: Discussionmentioning
confidence: 99%
“…Proinflamatuvar sitokinlerin hematopoetik öncül hücrelerin farklılaş-masını sağlayan reseptör aktivatör nükleer kappa B ligand (RANKL) üzerinden osteoklastların maturasyon ve çoğalmalarını uyararak kemik yıkımı yaptığı düşünülmektedir. Erişkin T hücreli lösemide RANKL düzeylerinde artış gösterilmiştir (5) . İlk kez bir akciğer kanseri vakasında gösterilen PTHrP'nın ise öncelikle kalsiyum ve fosfatın renaltübüler transportunu etkileyerek hiperkalsemi yaptığı düşü-nülmektedir (6) .…”
Section: Discussionunclassified