A Case of Hypercalcemia in the Blastic Phase of Chronic Myeloid Leukemia Associated with Elevated Parathyoid Hormone-related Protein / 대한내과학회지

ABSTRACT

Hypercalcemia is a rare complication of chronic myelogenous leukemia, especially in the blastic phase. The incidence is below 5%. PTH-rP (parathyroid hormone- related protein) plays various roles in human physiology by binding PTH receptors. The patient was 32-year-old male, admitted with blatic crisis of chronic myelogenous leukemia associated with hypercalcemia, elevated PTH-rP, depressed PTH level. Chemotherapy was instituted with hydroxyurea and two courses of idarubicin and Ara-C. After chemotherapy serum calcium and PTH-rP level, number of blast were depressed to near normal and PTH was elevated to normal range. But when the patient was re-admitted with recurrence of blastic crisis and hypercalcemia, PTH-rP level was elevated and PTH level was depressed below normal range. There was no other evidence of hypercalcemia as like hyperthyroidism or hyperparathyroidism, bone destruction. These suggest that the hypercalcemic event in this patient was induced by PTH-rP produced by blast cells.