The effects of calcitonin in hypercalcemia in patients with malignancy

Vaughn, Clarence B.; Vaitkevicius, Vainutis K.

doi:10.1002/1097-0142(197410)34:4<1268::aid-cncr2820340437>3.0.co;2-x

Cited by 39 publications

(14 citation statements)

References 14 publications

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“…Calcitonin (4‐8 U/kg intramuscularly or subcutaneously every 12 hours) has a rapid onset of action, but its effects are mild and often transient. Furthermore, patients develop tachyphylaxis to it within 48 hours . Calcitonin can be useful as an initial adjunct to hydration while waiting for other treatment modalities to take effect .…”

Section: Treatment Of Hcmmentioning

confidence: 99%

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Hypercalcemia and cancer: Differential diagnosis and treatment

Zagzag

Fisher

et al. 2018

CA A Cancer J Clinicians

113

112

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Incidentally detected hypercalcemia usually presents in an indolent manner and is most likely caused by primary hyperparathyroidism. In contrast, hypercalcemia in the patient with a history of cancer presents in a wide range of clinical settings and may be severe enough to warrant hospitalization. This form of hypercalcemia is usually secondary to hypercalcemia of malignancy and can be fatal. Hypercalcemia of malignancy is most commonly mediated by tumoral production of parathyroid hormone–related protein or by cytokines activating osteoclast degradation of bone. The initial workup, differential diagnoses, confirmatory laboratory testing, imaging, and medical and surgical management of hypercalcemia are described in the patient with cancer.

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Section: Treatment Of Hcmmentioning

confidence: 99%

“…Furthermore, patients develop tachyphylaxis to it within 48 hours. 85,86 Calcitonin can be useful as an initial adjunct to hydration while waiting for other treatment modalities to take effect. 47,66 Corticosteroids are useful in the treatment of HCM because of excess calcitriol production by lymphomas.…”

Section: Treatment Of Hcmmentioning

confidence: 99%

Hypercalcemia and cancer: Differential diagnosis and treatment

Zagzag

Fisher

et al. 2018

CA A Cancer J Clinicians

113

112

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“…In some countries, denosumab is approved for use in patients with bisphosphonate-refractory hypercalcaemia [53]. In addition, calcitonin may be useful for patients with severe or life-threatening hypercalcaemia because it causes a rapid, albeit transient, decrease of high serum calcium levels [46, 72]. …”

Section: Introductionmentioning

confidence: 99%

Hypercalcaemia and hypocalcaemia: finding the balance

Body

Niepel²,

Tonini

2017

Support Care Cancer

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Calcium metabolism in cancer and hypercalcaemia of malignancyThe balance between bone formation and resorption may be disrupted in patients with cancer, leading either to increased bone resorption, calcium release, and possibly hypercalcaemia, or to increased bone formation, sequestration of calcium, and possibly hypocalcaemia. In adults, hypercalcaemia of malignancy is most common in patients with tumours that produce factors that induce osteoclast activation and enhance bone resorption. Impaired renal function and increased renal tubular calcium resorption may further affect calcium levels.Treatment of hypercalcaemia of malignancyInhibitors of bone resorption, first the bisphosphonates and, later, denosumab, have been shown to be effective in hypercalcaemia treatment. Bisphosphonates (which are administered intravenously) are approved for hypercalcaemia of malignancy and are the current mainstay of treatment, whereas denosumab (which is administered subcutaneously) may offer an option for patients who do not respond to bisphosphonates or suffer from renal insufficiency.Hypocalcaemia: treatment and preventionHypocalcaemia is most common in patients with prostate cancer and osteoblastic bone metastases, but can occur in patients with a variety of tumour types who are receiving inhibitors of bone resorption. While patients often respond to calcium and vitamin D supplementation, prevention should be the aim; at-risk patients should be identified before starting treatment with inhibitors of bone resorption, be closely monitored during at least the first few months of treatment, and receive concomitant calcium and vitamin D supplementation unless hypercalcaemia is present.ConclusionBoth hypercalcaemia and hypocalcaemia can be serious if left untreated. It is therefore important that patients with cancer are closely monitored and receive adequate prevention and treatment measures to maintain normal blood calcium levels.

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“…Although a relatively weak agent, it works rapidly and decreases the serum calcium concentration by a maximum of 1 to 2mg/dL (0.3 to 0.5 mmol/L) beginning within 4 to 6 hours. 18 However, usually a tolerance is developed to its effect defined as tachyphylaxy. Therefore, it is not convenient for long-term management of hypercalcemia.…”

Section: Discussionmentioning

confidence: 99%

Severe Hypercalcemia in a Child With Acute Lymphoblastic Leukemia Relapse

Tağıyev

Demirbilek²,

Tavil³

et al. 2016

Journal of Pediatric Hematology/Oncology

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Hypercalcemia is a rare complication of hematological malignancy in children. An 8-year-old girl with CALLA (+) Pre-B-cell ALL developed hypercalcemia during bone marrow relapse. She had nausea, vomiting, leg pain, polyuria, polydipsia, and muscle weakness. At the time of relapse, the ionized calcium level was 1.99 mmol/L. Rehydration with 0.9% saline and furosemide and methylprednisolone (MP) treatment were used for the treatment of hypercalcemia. The serum ionized calcium level increased to 2.2 mmol/L despite hydration, furosemide, and MP treatment. Then, a single-dose pamidronate (1 mg/kg/dose) was administered. Despite pamidronate treatment, the calcium level continued to rise. Next, calcitonin at a dose of 8 IU/kg/dose, 4 doses per day, was added to the treatment. After commencement of calcitonin treatment, her ionized calcium level decreased to normal reference ranges. In conclusion, because of the postponed effect of bisphosphonate treatment, pamidronate and calcitonin combination is an effective treatment option in the early resolution of malignancy-related hypercalcemia.

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The effects of calcitonin in hypercalcemia in patients with malignancy

Cited by 39 publications

References 14 publications

Hypercalcemia and cancer: Differential diagnosis and treatment

Hypercalcemia and cancer: Differential diagnosis and treatment

Hypercalcaemia and hypocalcaemia: finding the balance

Severe Hypercalcemia in a Child With Acute Lymphoblastic Leukemia Relapse

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