Hypercalcemia in Small Lymphocytic Lymphoma with an Elevated Parathyroid Hormone-Related Peptide Associated with Early Richter Transformation

Hypercalcemia in malignancy is associated with multiple mechanisms and occurs in up to 20–30% of cancer patients. We report a case of small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) associated with hypercalcemia and an elevation in parathyroid hormone-related peptide (PTHrP) in the...

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Main Authors: Ashish Bains, Pedro Covas, Olga Timofeeva, Michael Bromberg
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2021/5525721
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author Ashish Bains
Pedro Covas
Olga Timofeeva
Michael Bromberg
author_facet Ashish Bains
Pedro Covas
Olga Timofeeva
Michael Bromberg
author_sort Ashish Bains
collection DOAJ
description Hypercalcemia in malignancy is associated with multiple mechanisms and occurs in up to 20–30% of cancer patients. We report a case of small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) associated with hypercalcemia and an elevation in parathyroid hormone-related peptide (PTHrP) in the setting of a Richter transformation. Real-time reverse transcriptase PCR on lymph node biopsy specimens obtained before and after transformation showed an 8-fold increase in PTHrP mRNA levels and about 2-fold decrease in the levels of its cognate receptor PTHR1. The findings of this case suggest that parathyroid hormone-related peptide might be useful in monitoring a specific group of patients with SLL/CLL who develop hypercalcemia during the course of their disease and could suggest an autocrine-like mechanism involving PTHrP in Richter transformation.
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spelling doaj-art-77efe93b1d99463f82aa3dbe9a1c2e9a2025-02-03T01:09:56ZengWileyCase Reports in Hematology2090-65602090-65792021-01-01202110.1155/2021/55257215525721Hypercalcemia in Small Lymphocytic Lymphoma with an Elevated Parathyroid Hormone-Related Peptide Associated with Early Richter TransformationAshish Bains0Pedro Covas1Olga Timofeeva2Michael Bromberg3Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USADepartment of Internal Medicine, George Washington University, Washington, DC, USADepartment of Pathology, Georgetown University Hospital, Washington, DC, USADepartment of Internal Medicine, Section of Hematology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USAHypercalcemia in malignancy is associated with multiple mechanisms and occurs in up to 20–30% of cancer patients. We report a case of small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) associated with hypercalcemia and an elevation in parathyroid hormone-related peptide (PTHrP) in the setting of a Richter transformation. Real-time reverse transcriptase PCR on lymph node biopsy specimens obtained before and after transformation showed an 8-fold increase in PTHrP mRNA levels and about 2-fold decrease in the levels of its cognate receptor PTHR1. The findings of this case suggest that parathyroid hormone-related peptide might be useful in monitoring a specific group of patients with SLL/CLL who develop hypercalcemia during the course of their disease and could suggest an autocrine-like mechanism involving PTHrP in Richter transformation.http://dx.doi.org/10.1155/2021/5525721
spellingShingle Ashish Bains
Pedro Covas
Olga Timofeeva
Michael Bromberg
Hypercalcemia in Small Lymphocytic Lymphoma with an Elevated Parathyroid Hormone-Related Peptide Associated with Early Richter Transformation
Case Reports in Hematology
title Hypercalcemia in Small Lymphocytic Lymphoma with an Elevated Parathyroid Hormone-Related Peptide Associated with Early Richter Transformation
title_full Hypercalcemia in Small Lymphocytic Lymphoma with an Elevated Parathyroid Hormone-Related Peptide Associated with Early Richter Transformation
title_fullStr Hypercalcemia in Small Lymphocytic Lymphoma with an Elevated Parathyroid Hormone-Related Peptide Associated with Early Richter Transformation
title_full_unstemmed Hypercalcemia in Small Lymphocytic Lymphoma with an Elevated Parathyroid Hormone-Related Peptide Associated with Early Richter Transformation
title_short Hypercalcemia in Small Lymphocytic Lymphoma with an Elevated Parathyroid Hormone-Related Peptide Associated with Early Richter Transformation
title_sort hypercalcemia in small lymphocytic lymphoma with an elevated parathyroid hormone related peptide associated with early richter transformation
url http://dx.doi.org/10.1155/2021/5525721
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