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. Acute lymphoblastic leukemia (ALL) is very rarely presented   with diffuse osteolytic lesions and hypercalcemia. Case Outline. We report a   28-year-old male with the B-cell ALL who presented with extensive osteolytic   lesions, bone pain, hepatosplenomegaly, and pancytopenia without circulating   blasts in peripheral blood. An increased serum level of tumor necrosis factor   (TNF-α) was registered while the levels of IL-1α and IL-1β were normal. The   patient failed to achieve remission on two induction regimens but achieved   one after the successful allogeneic stem cell transplantation, which lasted   for six months, after which he developed a relapse and died. Conclusion. The   presented case may serve as a clinical demonstration of possible involvement   of TNF-α as a pathogenic factor in the evolution of osteolytic lesions that   are occasionally observed in patients with ALL. This might have relevance in   the management of such patients as chemotherapy alone may not represent the   beneficial option in this clinical context

srpski arhiv za celokupno lekarstvo

Hypercalcemia with multiple osteolytic lesions and increased circulating tumor necrosis factor in an adult patient with B-cell acute lymphoblastic leukemia