Adult acute precursor B-cell lymphoblastic leukemia presenting as hypercalcemia and osteolytic bone lesions
Abstract Background Osteolytic bone lesions and hypercalcemia without peripheral blasts B-cell acute lymphoblastic leukemia (B-ALL) is reported in children but rarely seen in adults. Case presentation We describe the case of a 34-year old man presenting with hypercalcemia and symptomatic osteolytic...
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| Format: | Article |
| Language: | English |
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BMC
2017-04-01
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| Series: | Experimental Hematology & Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40164-017-0071-8 |
| _version_ | 1818158399428231168 |
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| author | Nikki Charlotta Paul Granacher Zwi N. Berneman Wilfried Schroyens Ann L. R. Van de Velde Anke Verlinden Alain P. A. Gadisseur |
| author_facet | Nikki Charlotta Paul Granacher Zwi N. Berneman Wilfried Schroyens Ann L. R. Van de Velde Anke Verlinden Alain P. A. Gadisseur |
| author_sort | Nikki Charlotta Paul Granacher |
| collection | DOAJ |
| description | Abstract Background Osteolytic bone lesions and hypercalcemia without peripheral blasts B-cell acute lymphoblastic leukemia (B-ALL) is reported in children but rarely seen in adults. Case presentation We describe the case of a 34-year old man presenting with hypercalcemia and symptomatic osteolytic bone lesions of vertebrae and ribs who was initially suspected as having a solid malignancy. Diagnostic work-up including peripheral blood examination, radiographic and nuclear studies could, however, not detect a primary tumor. Because of a mild thrombocytopenia and the lack of a primary focus, a bone marrow biopsy was performed leading to the diagnosis of Philadelphia chromosome positive precursor B-ALL. After correction of the hypercalcemia with intravenous fluid administration, corticoids and bisphosphonates, the patient was treated according to the HOVON 100 protocol achieving complete molecular remission after the first cycle of induction chemotherapy. Conclusion Hypercalcemia and osteolytic bone lesions are rare complications of adult B-ALL and can occur in the absence of peripheral blastosis. With this case report we would like to emphasize the importance of clinical awareness. Immediate treatment of hypercalcemia and initiation of antileukemic treatment is mandatory as a delay of diagnosis might pose a real and possible life-threatening risk in these patients. |
| first_indexed | 2024-12-11T15:29:28Z |
| format | Article |
| id | doaj.art-d532421bfba3440885d27fff29bba382 |
| institution | Directory Open Access Journal |
| issn | 2162-3619 |
| language | English |
| last_indexed | 2024-12-11T15:29:28Z |
| publishDate | 2017-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Experimental Hematology & Oncology |
| spelling | doaj.art-d532421bfba3440885d27fff29bba3822022-12-22T01:00:06ZengBMCExperimental Hematology & Oncology2162-36192017-04-01611410.1186/s40164-017-0071-8Adult acute precursor B-cell lymphoblastic leukemia presenting as hypercalcemia and osteolytic bone lesionsNikki Charlotta Paul Granacher0Zwi N. Berneman1Wilfried Schroyens2Ann L. R. Van de Velde3Anke Verlinden4Alain P. A. Gadisseur5Division of Hematology, Antwerp University HospitalDivision of Hematology, Antwerp University HospitalDivision of Hematology, Antwerp University HospitalDivision of Hematology, Antwerp University HospitalDivision of Hematology, Antwerp University HospitalDivision of Hematology, Antwerp University HospitalAbstract Background Osteolytic bone lesions and hypercalcemia without peripheral blasts B-cell acute lymphoblastic leukemia (B-ALL) is reported in children but rarely seen in adults. Case presentation We describe the case of a 34-year old man presenting with hypercalcemia and symptomatic osteolytic bone lesions of vertebrae and ribs who was initially suspected as having a solid malignancy. Diagnostic work-up including peripheral blood examination, radiographic and nuclear studies could, however, not detect a primary tumor. Because of a mild thrombocytopenia and the lack of a primary focus, a bone marrow biopsy was performed leading to the diagnosis of Philadelphia chromosome positive precursor B-ALL. After correction of the hypercalcemia with intravenous fluid administration, corticoids and bisphosphonates, the patient was treated according to the HOVON 100 protocol achieving complete molecular remission after the first cycle of induction chemotherapy. Conclusion Hypercalcemia and osteolytic bone lesions are rare complications of adult B-ALL and can occur in the absence of peripheral blastosis. With this case report we would like to emphasize the importance of clinical awareness. Immediate treatment of hypercalcemia and initiation of antileukemic treatment is mandatory as a delay of diagnosis might pose a real and possible life-threatening risk in these patients.http://link.springer.com/article/10.1186/s40164-017-0071-8Adult precursor B-cell lymphoblastic leukemiaCase reportHypercalcemiaOsteolysisPhiladelphia chromosome |
| spellingShingle | Nikki Charlotta Paul Granacher Zwi N. Berneman Wilfried Schroyens Ann L. R. Van de Velde Anke Verlinden Alain P. A. Gadisseur Adult acute precursor B-cell lymphoblastic leukemia presenting as hypercalcemia and osteolytic bone lesions Experimental Hematology & Oncology Adult precursor B-cell lymphoblastic leukemia Case report Hypercalcemia Osteolysis Philadelphia chromosome |
| title | Adult acute precursor B-cell lymphoblastic leukemia presenting as hypercalcemia and osteolytic bone lesions |
| title_full | Adult acute precursor B-cell lymphoblastic leukemia presenting as hypercalcemia and osteolytic bone lesions |
| title_fullStr | Adult acute precursor B-cell lymphoblastic leukemia presenting as hypercalcemia and osteolytic bone lesions |
| title_full_unstemmed | Adult acute precursor B-cell lymphoblastic leukemia presenting as hypercalcemia and osteolytic bone lesions |
| title_short | Adult acute precursor B-cell lymphoblastic leukemia presenting as hypercalcemia and osteolytic bone lesions |
| title_sort | adult acute precursor b cell lymphoblastic leukemia presenting as hypercalcemia and osteolytic bone lesions |
| topic | Adult precursor B-cell lymphoblastic leukemia Case report Hypercalcemia Osteolysis Philadelphia chromosome |
| url | http://link.springer.com/article/10.1186/s40164-017-0071-8 |
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