Hypercalcemia Associated With Chronic Lymphocytic Leukemia

Na, De Souza e Silva; Dm, Wilson

doi:10.1080/00325481.1973.11713488

Cited by 6 publications

(2 citation statements)

References 30 publications

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“…reported elevated parathyroid hormone levels in a hypercalcemic 47-year-old man with chronic lymphocytic leukemia but attributed them to significant renal impairment. 6 Norrby et a / . found low-normal parathyroid hormone levels in a 65-year-old man with chronic lymphocytic leukemia and hypercalcemia and did not implicate a causal effect.…”

Section: Discussionmentioning

confidence: 99%

Hypercalcemia in the accelerated phase of chronic myelogenous leukemia

Walter

Greenberg

1980

Cancer

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Within a recent one-year period, 3 patients in the accelerated phase of chronic myelogenous leukemia were admitted to our medical center with severe hypercalcemia. Simultaneous determinations of ionized calcium and parathyroid hormone levels in 2 of the patients confirmed the hypercalcemia and revealed suppression of parathyroid hormone. We conclude that hypercalcemia in the accelerated phase of chronic myelogeneous leukemia may be more common than previously described and is not mediated by parathyroid hormone. An elevated parathyroid hormone level accompanying hypercalcemia in these patients should suggest the additional diagnosis of primary hyperparathyroidism. Mithramycin was necessary for control in 2 of our cases as well as in others reported in the medical literature and should be an early therapeutic consideration whenever saline diuresis is inadequate.

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Section: Discussionmentioning

confidence: 99%

Hypercalcemia in the accelerated phase of chronic myelogenous leukemia

Walter

Greenberg

1980

Cancer

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“…Ungeklärt bleibt die Frage, ob Mithramycin einen hemmenden Einfluß auf die Calciumaufnahme im Darm ausübt. Das verwandte Actinomycin D scheint eine Rolle bei der Calciumresorption zu spielen(34).Die Wirksamkeit von Mithramycin bei unseren Tumorpatienten entspricht den Erfahrungen ausländischer, vorwiegend nordamerikanischer Autoren (10, 12, 28,34,35,41). Beeindruckend sind die Regelmäßigkeit des calciumspiegelsenkenden Effekts und der rasche, jedoch nicht brüske und überschießende Wirkungseintritt.…”

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Die Therapie des Hypercalcämiesyndroms bei Tumorpatienten^*- mit besonderer Berücksichtigung von Mithramycin

Hj¹,

Peyer²

1978

Dtsch med Wochenschr

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In 36 patients with neoplastic diseases 72 episodes of hypercalcaemia with serum-calcium levels greater than or equal to 2.75 mmol/l were treated (19 breast carcinoma; 9 bronchial or lung carcinoma; 5 multiple myeloma; 1 each jejunal carcinoid, malignant lymphoma, phaeochromocytoma). Cardinal symptoms were mental, neuromuscular and renal during the hypercalcaemic episodes. Mithramycin is preferred to other methods (infusion of sodium chloride and frusemide, prednisone, sodium-potassium-phosphate infusion) of treating acute or subacute hypercalcaemia. Mithramycin in a single injection of 20-25 microgram/kg body-weight intravenously is usually sufficient to counteract a hypercalcaemic phase for at least 7-10 days, often much longer. There was a highly significant fall in serum-calcium levels from two days onwards after mithramycin injection. Toxic side-effects were minimal and restricted to transitory increase in transaminase levels, initially 5-6 times normal with a maximum on the third day and normalisation on the fifth day after mithramycin administration.

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