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Cytogenetics and Molecular Genetics

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

Leukemia volume 21, pages 288–296 (2007)Cite this article

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 × 109/l), 15 showed hemoglobin⩾8 g/dl and 14 showed platelet count ⩾100 × 109/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.

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Acknowledgements

We thank Masahiro Tsuchida (Department of Pediatrics, Ibaraki Children's Hospital, Mito, Japan) for providing the clinical data of TCCSG and Keiko Kagami (Department of Pediatrics, University of Yamanashi, School of Medicine) for technical supports.

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Authors and Affiliations

  1. Department of Pediatrics, University of Yamanashi, School of Medicine, Yamanashi, Japan

    T Inukai, K Hirose, K Goi, S Nakazawa & K Sugita

  2. Department of Molecular Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    T Inaba

  3. Department of Pediatrics, Dokkyo University School of Medicine, Tochigi, Japan

    H Kurosawa

  4. Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan

    A Hama

  5. Department of Pediatrics, Kurume University School of Medicine, Kurume, Japan

    H Inada

  6. Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan

    M Chin

  7. Section of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan

    Y Nagatoshi

  8. Division of Cellular Therapy, Institute of Medical Science, University of Tokyo, Tokyo, Japan

    Y Ohtsuka

  9. Department of Pediatrics, Okayama University Medical School, Okayama, Japan

    M Oda

  10. Department of Pediatrics, Yokohama City University School of Medicine, Yokohama, Japan

    H Goto

  11. Department of Pediatrics, Iwate Medical University School of Medicine, Morioka, Japan

    M Endo

  12. Department of Pediatrics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan

    A Morimoto

  13. Department of Hematology and Oncology, Miyagi Children's Hospital, Sendai, Japan

    M Imaizumi

  14. Department of Pediatrics, Osaka Rosai Hospital, Sakai, Japan

    N Kawamura

  15. Section of Pediatrics, Anjo Kosei Hospital, Anjo, Japan

    Y Miyajima

  16. Department of Pediatrics, Sendai City Hospital, Sendai, Japan

    M Ohtake

  17. Department of Pediatrics, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan

    R Miyaji

  18. Department of Pediatrics and Adolescent, Juntendo University School of Medicine, Tokyo, Japan

    M Saito

  19. Section of Pediatrics, National Hospital Organization Osaka National Hospital, Osaka, Japan

    A Tawa

  20. Department of Pediatrics, Fukuoka University School of Medicine, Fukuoka, Japan

    F Yanai

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  1. T Inukai
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Correspondence to T Inukai.

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Inukai, T., Hirose, K., Inaba, T. et al. Hypercalcemia in childhood acute lymphoblastic leukemia: frequent implication of parathyroid hormone-related peptide and E2A-HLF from translocation 17;19. Leukemia 21, 288–296 (2007). https://doi.org/10.1038/sj.leu.2404496

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  • DOI: https://doi.org/10.1038/sj.leu.2404496

Keywords

  • hypercalcemia
  • childhood ALL
  • PTHrP
  • E2A-HLF
  • bisphosphonate

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