Hypercalcemia with multiple osteolytic lesions and increased circulating tumor necrosis factor in an adult patient with B-cell acute lymphoblastic leukemia

Abstract

The presented case may serve as a clinical demonstration of possible involvement of TNF-α as a pathogenic factor in the evolution of osteolytic lesions that are occasionally observed in patients with ALL. This might have relevance in the management of such patients as chemotherapy alone may not represent the beneficial option in this clinical context.

Case report: BCR-ABL-positive acute lymphoblastic leukemia with bone destruction: a treatment dilemma

“…The patient in this case report first experienced back pain, gradually progressed to multiple bone destructions, and was finally diagnosed after the appearance of peripheral primitive and immature lymphocytes. Although a few similar cases have been reported, the cases were BCR-ABL-negative ALL (2,4,8,11), different from that reported in this study, making this case extremely rare.…”

“…However, multiple bone destruction is rare in both children and adults with ALL ( 4 , 9 , 10 ). Among adult malignant tumors, multiple bone destruction incidence is 27%–35% in lung cancer, 25%–30% in breast cancer, 7%–30% in multiple myeloma, < 10% in malignant lymphoma, and < 1% in leukemia ( 2 ). The patient in this case report first experienced back pain, gradually progressed to multiple bone destructions, and was finally diagnosed after the appearance of peripheral primitive and immature lymphocytes.…”

“…Its clinical manifestations are the same as those of other ALL cases, including infection, hemorrhage, anemia, lymphadenopathy, hepatosplenomegaly, and central nervous system infiltration. Bone destruction and hypercalcemia are rare in ALL, except for in adult T-cell leukemia/lymphoma (ATLL) ( 2 ). Few case reports on osteolytic lesions have been published.…”

Hypercalcemia and Lytic Bone Lesions As a Rare Presentation of Acute Lymphoblastic Leukemia: A Case Report

“…B-cell ALL rarely presents with hypercalcemia in adults. We could find 10 cases in the literature, i.e., illustrated in Table 1 [7][8][9][10][11][12]. In the reported cases, the range of patients' age was 22-53 years.…”

Hypercalcemia With Disseminated Osteolytic Lesions: A Rare Presentation of Adulthood Acute Lymphoblastic Leukemia

“…The incidence of hypercalcemia varied from 50% to 90% in ATLL, from 27% to 35% in lung cancer, from 25% to 30% in breast cancer, between 7% and 30% in multiple myeloma, less than 10% in malignant lymphoma and even less than 1% in leukemia patients [3].…”