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

Ashish Bains | Zendy; Pedro Covas | Zendy; Olga Timofeeva | Zendy; Michael Bromberg | Zendy

Open Access

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

Author(s) -

Ashish Bains,

Pedro Covas,

Olga Timofeeva,

Michael Bromberg

Publication year - 2021

Publication title -

case reports in hematology

Language(s) - English

Resource type - Journals

eISSN - 2090-6560

pISSN - 2090-6579

DOI - 10.1155/2021/5525721

Subject(s) - medicine , chronic lymphocytic leukemia , malignancy , parathyroid hormone , autocrine signalling , lymphoma , lymph node biopsy , lymph node , endocrinology , calcium sensing receptor , receptor , cancer research , leukemia , calcium

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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