Hypercalcemia in childhood acute lymphoblastic leukemia: frequent implication of parathyroid hormone-related peptide and E2A-HLF from translocation 17;19.

Abstract

Hypercalcemia is relatively rare but clinically important complication in childhood leukemic patients. To clarify the clinical characteristics, mechanisms of hypercalcemia, response to management for hypercalcemia, incidence of t(17;19) and final outcome of childhood acute lymphoblastic leukemia (ALL) accompanied by hypercalcemia, clinical data of 22 cases of childhood ALL accompanied by hypercalcemia (>12 mg/dl) reported in Japan from 1990 to 2005 were retrospectively analyzed. Eleven patients were 10 years and older. Twenty patients had low white blood cell count (<20 x 10(9)/l), 15 showed hemoglobin> or =8 g/dl and 14 showed platelet count > or =100 x 10(9)/l. Parathyroid hormone-related peptide (PTHrP)-mediated hypercalcemia was confirmed in 11 of the 16 patients in whom elevated-serum level or positive immunohistochemistry of PTHrP was observed. Hypercalcemia and accompanying renal insufficiency resolved quickly, particularly in patients treated with bisphosphonate. t(17;19) or add(19)(p13) was detected in five patients among 17 patients in whom karyotypic data were available, and the presence of E2A-HLF was confirmed in these five patients. All five patients with t(17;19)-ALL relapsed very early. Excluding the t(17;19)-ALL patients, the final outcome of ALL accompanied by hypercalcemia was similar to that of all childhood ALL patients, indicating that the development of hypercalcemia itself is not a poor prognostic factor.

• Authors: T Inukai, K Hirose, T Inaba, H Kurosawa, A Hama, H Inada, M Chin, Y Nagatoshi, Y Ohtsuka, M Oda, H Goto, M Endo, A Morimoto, M Imaizumi, N Kawamura, Y Miyajima, M Ohtake, R Miyaji, M Saito, A Tawa, F Yanai, K Goi, S Nakazawa, K Sugita
• Journal: Leukemia (Leukemia) Vol. 21 Issue 2 Pg. 288-96 (Feb 2007) ISSN: 0887-6924 [Print] England
• PMID: 17183364 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• DNA-Binding Proteins
• E2a-Hlf fusion protein, human
• Oncogene Proteins, Fusion
• Parathyroid Hormone-Related Protein
• Transcription Factors
• Calcium

Topics

• Adolescent
• Calcium (blood)
• Child
• Child, Preschool
• Chromosomes, Human, Pair 17
• Chromosomes, Human, Pair 19
• DNA-Binding Proteins (genetics)
• Female
• Humans
• Hypercalcemia (complications, genetics)
• Male
• Oncogene Proteins, Fusion (genetics)
• Parathyroid Hormone-Related Protein (genetics)
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (blood, complications, genetics)
• Reproducibility of Results
• Reverse Transcriptase Polymerase Chain Reaction
• Transcription Factors (genetics)
• Translocation, Genetic