The Alkaline Phosphatase Flare Phenomenon: A Transient Substantial Increase in Alkaline Phosphatase Concentration in a Prostate Cancer Patient after Starting GnRH Agonist Treatment
A 78-year-old man with metastatic prostate cancer was referred to the hospital 5 weeks after the initiation of systemic therapy with goserelin (GnRH agonist) because of a significant increase in alkaline phosphatase (ALP) concentration despite clinical improvement. Further workup revealed a decrease...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2021-02-01
|
| Series: | Case Reports in Oncology |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/513427 |
| _version_ | 1818914907740962816 |
|---|---|
| author | Pierina Merlo Christoph Rochlitz Michael Osthoff |
| author_facet | Pierina Merlo Christoph Rochlitz Michael Osthoff |
| author_sort | Pierina Merlo |
| collection | DOAJ |
| description | A 78-year-old man with metastatic prostate cancer was referred to the hospital 5 weeks after the initiation of systemic therapy with goserelin (GnRH agonist) because of a significant increase in alkaline phosphatase (ALP) concentration despite clinical improvement. Further workup revealed a decrease in prostate-specific antigen levels and a lack of radiological signs of disease progression. Subsequently, the ALP dropped spontaneously. This case report is an example for an early ALP flare after initiation of endocrine therapy in patients with bone metastasis which is consistent with a treatment response. Clinicians should be familiar with the ALP flare phenomenon in this setting, which does not reflect disease progression or treatment failure, in order to prevent unnecessary investigations, hospital admissions, or even erroneous termination of successful therapy. |
| first_indexed | 2024-12-19T23:53:51Z |
| format | Article |
| id | doaj.art-f315399e9e0242c49a068e07ae534b48 |
| institution | Directory Open Access Journal |
| issn | 1662-6575 |
| language | English |
| last_indexed | 2024-12-19T23:53:51Z |
| publishDate | 2021-02-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Oncology |
| spelling | doaj.art-f315399e9e0242c49a068e07ae534b482022-12-21T20:01:03ZengKarger PublishersCase Reports in Oncology1662-65752021-02-01141737710.1159/000513427513427The Alkaline Phosphatase Flare Phenomenon: A Transient Substantial Increase in Alkaline Phosphatase Concentration in a Prostate Cancer Patient after Starting GnRH Agonist TreatmentPierina MerloChristoph RochlitzMichael OsthoffA 78-year-old man with metastatic prostate cancer was referred to the hospital 5 weeks after the initiation of systemic therapy with goserelin (GnRH agonist) because of a significant increase in alkaline phosphatase (ALP) concentration despite clinical improvement. Further workup revealed a decrease in prostate-specific antigen levels and a lack of radiological signs of disease progression. Subsequently, the ALP dropped spontaneously. This case report is an example for an early ALP flare after initiation of endocrine therapy in patients with bone metastasis which is consistent with a treatment response. Clinicians should be familiar with the ALP flare phenomenon in this setting, which does not reflect disease progression or treatment failure, in order to prevent unnecessary investigations, hospital admissions, or even erroneous termination of successful therapy.https://www.karger.com/Article/FullText/513427alkaline phosphataseflare metastatic prostate cancergnrh agonist |
| spellingShingle | Pierina Merlo Christoph Rochlitz Michael Osthoff The Alkaline Phosphatase Flare Phenomenon: A Transient Substantial Increase in Alkaline Phosphatase Concentration in a Prostate Cancer Patient after Starting GnRH Agonist Treatment Case Reports in Oncology alkaline phosphatase flare metastatic prostate cancer gnrh agonist |
| title | The Alkaline Phosphatase Flare Phenomenon: A Transient Substantial Increase in Alkaline Phosphatase Concentration in a Prostate Cancer Patient after Starting GnRH Agonist Treatment |
| title_full | The Alkaline Phosphatase Flare Phenomenon: A Transient Substantial Increase in Alkaline Phosphatase Concentration in a Prostate Cancer Patient after Starting GnRH Agonist Treatment |
| title_fullStr | The Alkaline Phosphatase Flare Phenomenon: A Transient Substantial Increase in Alkaline Phosphatase Concentration in a Prostate Cancer Patient after Starting GnRH Agonist Treatment |
| title_full_unstemmed | The Alkaline Phosphatase Flare Phenomenon: A Transient Substantial Increase in Alkaline Phosphatase Concentration in a Prostate Cancer Patient after Starting GnRH Agonist Treatment |
| title_short | The Alkaline Phosphatase Flare Phenomenon: A Transient Substantial Increase in Alkaline Phosphatase Concentration in a Prostate Cancer Patient after Starting GnRH Agonist Treatment |
| title_sort | alkaline phosphatase flare phenomenon a transient substantial increase in alkaline phosphatase concentration in a prostate cancer patient after starting gnrh agonist treatment |
| topic | alkaline phosphatase flare metastatic prostate cancer gnrh agonist |
| url | https://www.karger.com/Article/FullText/513427 |
| work_keys_str_mv | AT pierinamerlo thealkalinephosphataseflarephenomenonatransientsubstantialincreaseinalkalinephosphataseconcentrationinaprostatecancerpatientafterstartinggnrhagonisttreatment AT christophrochlitz thealkalinephosphataseflarephenomenonatransientsubstantialincreaseinalkalinephosphataseconcentrationinaprostatecancerpatientafterstartinggnrhagonisttreatment AT michaelosthoff thealkalinephosphataseflarephenomenonatransientsubstantialincreaseinalkalinephosphataseconcentrationinaprostatecancerpatientafterstartinggnrhagonisttreatment AT pierinamerlo alkalinephosphataseflarephenomenonatransientsubstantialincreaseinalkalinephosphataseconcentrationinaprostatecancerpatientafterstartinggnrhagonisttreatment AT christophrochlitz alkalinephosphataseflarephenomenonatransientsubstantialincreaseinalkalinephosphataseconcentrationinaprostatecancerpatientafterstartinggnrhagonisttreatment AT michaelosthoff alkalinephosphataseflarephenomenonatransientsubstantialincreaseinalkalinephosphataseconcentrationinaprostatecancerpatientafterstartinggnrhagonisttreatment |