An instructive case of hypercalcemia preceding relapse of AML following allogeneic BMT.

摘要

Hypercalcemia is rarely seen in childhood malignancies and the incidence has been reported to range from 0.4 to 1.3%. The most common malignancies associated with hypercalcemia include AML and lymphoma, and solid tumors such as rhabdomyosarcoma and neuroblastoma. Among the hematological malignancies, hypercalcemia is an extremely rare complication of ALL. We report on an 18-year-old male BMT recipient who presented with profound hypercalcemia and bone pain that preceded relapse of monosomy 7-positive AML by 3 weeks.An 18-year-old man presented with low back and left knee pain 38 days after a matched sibling allogeneic BMT for multiply relapsed monosomy 7-positive AML. Following transplant, he demonstrated no signs or symptoms of GVHD and remained on cyclosporine for GVHD prophylaxis. Within 48 h of admission, his left knee had become markedly swollen and painful. Initial laboratory evaluation revealed an elevated serum calcium level of 13.4mg per 100 mL that later peaked at 16.2 mg per 100 mL.