Medical ProgressHypercalcemia in Acute Lymphoblastic Leukemia An OverviewTrehan, Amita MD*; Cheetham, Timothy MBChB, MD†; Bailey, Simon MBChB, PhD‡ Author Information *Advanced Paediatric Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India †Department of Paediatric Endocrinology ‡Department of Paediatric Oncology, Sir James Spence Institute of Child Health, Royal Victoria Infirmary, Newcastle upon Tyne, UK Reprints: Simon Bailey, MBChB, PhD, Department of Paediatric Endocrinology, Sir James Spence Institute of Child Health, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK NE1 4LP (e-mail: [email protected]). Received for publication December 18, 2008; accepted February 14, 2009 Journal of Pediatric Hematology/Oncology 31(6):p 424-427, June 2009. | DOI: 10.1097/MPH.0b013e3181a1c12b Buy Metrics Abstract Hypercalcemia usually results in nonspecific constitutional symptoms, although it can also manifest as a life threatening metabolic emergency. It is an uncommon albeit well recognized biochemical feature of childhood malignancies including acute leukemia. The pathogenesis of hypercalcemia and its implications in terms of long-term outcome are not yet fully understood. Most of the children presenting with acute lymphoblastic leukemia and hypercalcemia tend to be in older age groups and have an absence of blasts in the peripheral blood film. The chromosomal translocation 17;19 seems to be more frequent in children who present with hypercalcemia but the presence of hypercalcemia by itself does not seem to be closely linked to prognosis. Some of the less common immunophenotypes in the form of CD19 negativity and CD10 positivity have also been observed in hypercalcemic patients. In this study, we shall illustrate this clinical problem using the details of 2 patients with hematologic malignancy who were found to be hypercalcemic at presentation. We shall also review the literature with particular emphasis on the pathogenesis of hypercalcemia, its associations, and relationship to outcome. © 2009 Lippincott Williams & Wilkins, Inc.