PTHrP-Induced Refractory Malignant Hypercalcemia in a Patient With Chronic Lymphocytic Leukemia Responding to Denosumab

Salahudeen, Ameen A.; Gupta, Arjun; Jones, Jeremy C.; Cowan, Robert W.; Vusirikala, Madhuri; Kwong, Chi Yin; Naina, Harris V.

doi:10.1016/j.clml.2015.06.007

Cited by 10 publications

(4 citation statements)

References 10 publications

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“…Hypercalcemia in CLL is extremely rare but ∼30 cases have been reported [ 47–49 ]. In a retrospective study of 1200 patients with CLL, 7 patients had high calcium levels [ 50 ].…”

Section: Electrolyte Disordersmentioning

confidence: 99%

Renal involvement in chronic lymphocytic leukemia

Wanchoo

Ramirez

Barrientos

et al. 2018

Clinical Kidney Journal

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Chronic lymphocytic leukemia (CLL) is the most commonly diagnosed adult leukemia in the USA and Western Europe. Kidney disease can present in patients with CLL as a manifestation of the disease process such as acute kidney injury with infiltration or with a paraneoplastic glomerular disease or as a manifestation of extra renal obstruction and tumor lysis syndrome. In the current era of novel targeted therapies, kidney disease can also present as a complication of treatment. Tumor lysis syndrome associated with novel agents such as the B-cell lymphoma 2 inhibitor venetoclax and the monoclonal antibody obinutuzumab are important nephrotoxicities associated with these agents. Here we review the various forms of kidney diseases associated with CLL and its therapies.

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“…Hypercalcemia in CLL is extremely rare but ∼30 cases have been reported [ 47–49 ]. In a retrospective study of 1200 patients with CLL, 7 patients had high calcium levels [ 50 ].…”

Section: Electrolyte Disordersmentioning

confidence: 99%

Renal involvement in chronic lymphocytic leukemia

Wanchoo

Ramirez

Barrientos

et al. 2018

Clinical Kidney Journal

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“…The expected maximum drop in serum calcium is 2 mg/dL within 4 hours, and it is usually given no longer than 48 hours as tachyphylaxis can occur 17. Denosumab is a monoclonal antibody against RANKL; that is effective in refractory PTHrP-induced malignant hypercalcaemia and was more efficacious than zoledronic acid in delaying and preventing hypercalcaemia in patients with advanced cancers 18 19…”

Section: Discussionmentioning

confidence: 99%

Humoral hypercalcaemia of malignancy associated with a gigantic cutaneous squamous cell carcinoma

et al. 2022

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Humoral hypercalcaemia of malignancy is rarely associated with cutaneous squamous cell carcinoma (SCC), and only a few cases have been reported in the medical literature. We present an interesting case of a gigantic cutaneous SCC associated with severe hypercalcaemia.A man in his mid 80s presented with a rapidly enlarging fungating mass of his scalp for 5 months. Laboratory studies logged severe hypercalcaemia, low intact parathyroid hormone, elevated parathyroid hormone related-peptide and normal 1,25 dihydroxy vitamin D. Skin biopsy revealed moderately differentiated invasive SCC. Further workup was negative for distant skeletal metastases. Severe hypercalcaemia was managed by intravenous fluids, bisphosphonates and calcitonin. A multidisciplinary approach was then made; the patient received radiotherapy and then underwent a successful surgical resection. By presenting this case, we aim to raise physicians’ awareness of the association between cutaneous SCC and hypercalcaemia. Severe hypercalcaemia should be detected early and promptly managed as it could be fatal.

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“…Hypercalcemia of malignancy (HCM) portends a very poor prognosis and is an oncologic emergency that can occur in 10-20% of adult cancer patients 1 . Studies suggest that denosumab, a monoclonal antibody that inhibits the signaling of receptor activator of nuclear factor kappa-B ligand (RANKL), a key factor for osteoclast differentiation and activation, provides benefit in cases of bisphosphonate-refractory hypercalcemia 12,13 . The calcimimetic agent, cinacalcet, is approved for treatment of both benign parathyroid disorders and parathyroid carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Hypercalcemia of Malignancy Attributed to Cosecretion of PTH and PTHRP in Lung Adenocarcinoma

Kroopnick

Martinez‐Outschoorn

Tuluc

et al. 2021

AACE Clinical Case Reports

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PTHrP-Induced Refractory Malignant Hypercalcemia in a Patient With Chronic Lymphocytic Leukemia Responding to Denosumab

Cited by 10 publications

References 10 publications

Renal involvement in chronic lymphocytic leukemia

Renal involvement in chronic lymphocytic leukemia

Humoral hypercalcaemia of malignancy associated with a gigantic cutaneous squamous cell carcinoma

Hypercalcemia of Malignancy Attributed to Cosecretion of PTH and PTHRP in Lung Adenocarcinoma

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