Clinical evaluation of calcium metabolism in adult T-cell leukemia/lymphoma.

To clarify the mechanism of development of hypercalcemia in adult T-cell leukemia/lymphoma (ATLL), ten patients with a serum creatinine level less than 177 mumol/L (2 mg/dL) were examined. Although hypercalcemia was seen in only four (40%) of these patients, four of six normocalcemic patients showed hypercalciuria (greater than 5 mmol/d [greater than 200 mg/24 h]). All hypercalcemic patients exhibited high nephrogenous cyclic adenosine monophosphate (NcAMP) levels in the face of low-normal immunoreactive parathyroid hormone and reduced serum 1,25-dihydroxyvitamin D [1,25(OH)2D] concentration. Half of the hypercalciuric patients with normocalcemia also showed high NcAMP and reduced serum 1,25(OH)2D levels. Furthermore, the changes in NcAMP and serum 1,25(OH)2D concentration closely paralleled the development of hypercalcemia and hypercalciuria in two patients. These results are reminiscent of the syndrome of humoral hypercalcemia of malignancy and suggest that derangements in calcium metabolism develop by a similar mechanism in patients with ATLL. The present data also indicate the importance of the measurement of urinary calcium excretion for early detection and prevention of fatal hypercalcemia in patients with ATLL.

[1]  H. Koeffler,et al.  25-Hydroxyvitamin D3 metabolism by human T-lymphotropic virus-transformed lymphocytes. , 1987, The Journal of clinical endocrinology and metabolism.

[2]  L. Suva,et al.  Parathyroid hormone-related protein purified from a human lung cancer cell line. , 1987, Proceedings of the National Academy of Sciences of the United States of America.

[3]  K. Yamaguchi,et al.  Hypercalcemia and osteoclast proliferation in adult T‐cell leukemia , 1987, Cancer.

[4]  P. Bunn,et al.  Calcitriol levels in hypercalcemic patients with adult T-cell lymphoma. , 1986, Archives of internal medicine.

[5]  R. Rizzoli,et al.  Parathyroid hormone-like changes in renal calcium and phosphate reabsorption induced by Leydig cell tumor in thyroparathyroidectomized rats. , 1986, Endocrinology.

[6]  J. Dunn,et al.  Production of 1,25-dihydroxyvitamin D3 by human T cell lymphotrophic virus-I-transformed lymphocytes. , 1986, The Journal of clinical investigation.

[7]  G. Mundy,et al.  Tumor products and the hypercalcemia of malignancy. , 1985, The Journal of clinical investigation.

[8]  S. Ralston,et al.  Hypercalcaemia of malignancy: evidence for a nonparathyroid humoral agent with an effect on renal tubular handling of calcium. , 1984, Clinical science.

[9]  W. Blattner,et al.  Clinical course of retrovirus-associated adult T-cell lymphoma in the United States. , 1983, The New England journal of medicine.

[10]  A. F. Stewart,et al.  Identification of adenylate cyclase-stimulating activity and cytochemical glucose-6-phosphate dehydrogenase-stimulating activity in extracts of tumors from patients with humoral hypercalcemia of malignancy. , 1983, Proceedings of the National Academy of Sciences of the United States of America.

[11]  Yasuaki Yamada,et al.  Clinical, hematologic, and pathologic features of leukemic T‐cell lymphoma , 1982, Cancer.

[12]  P. Bunn,et al.  Skeletal manifestations in cutaneous T-cell lymphomas. , 1982, Archives of dermatology.

[13]  M. Yoshida,et al.  Isolation and characterization of retrovirus from cell lines of human adult T-cell leukemia and its implication in the disease. , 1982, Proceedings of the National Academy of Sciences of the United States of America.

[14]  A. F. Stewart,et al.  Malignancy-associated hypercalcemia: evaluation with a cytochemical bioassay for parathyroid hormone. , 1981, The Journal of clinical endocrinology and metabolism.

[15]  E. Jaffe,et al.  Hypercalcemia associated with T-cell lymphoma-leukemia. , 1981, American journal of clinical pathology.

[16]  A. F. Stewart,et al.  Biochemical evaluation of patients with cancer-associated hypercalcemia: evidence for humoral and nonhumoral groups. , 1980, The New England journal of medicine.

[17]  John D. Minna,et al.  Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma , 1980, Proceedings of the National Academy of Sciences.

[18]  M. Ui,et al.  An ultrasensitive method for the simultaneous determination of cyclic AMP and cyclic GMP in small-volume samples from blood and tissue. , 1977, Biochemical medicine.

[19]  A. Broadus,et al.  Nephrogenous cyclic adenosine monophosphate as a parathyroid function test. , 1977, The Journal of clinical investigation.

[20]  J. Yodoi,et al.  Adult T-cell leukemia: clinical and hematologic features of 16 cases. , 1977, Blood.

[21]  H. DeLuca,et al.  A sensitive, precise, and convenient method for determination of 1,25-dihydroxyvitamin D in human plasma. , 1976, Archives of biochemistry and biophysics.

[22]  O. Bijvoet,et al.  NOMOGRAM FOR DERIVATION OF RENAL THRESHOLD PHOSPHATE CONCENTRATION , 1975, The Lancet.

[23]  Eisenberg,et al.  Interpretation of Serum Calcium in Patients with Abnormal Serum Proteins , 1973, British medical journal.

[24]  J. Haddad,et al.  COMPETITIVE PROTEIN-BINDING RADIOASSAY FOR 25-HYDROXYCHOLECALCIFEROL1 , 1971 .

[25]  A. F. Stewart,et al.  Nephrogenous cyclic AMP, adenylate cyclase-stimulating activity, and the humoral hypercalcemia of malignancy. , 1986, Recent progress in hormone research.

[26]  E. Frenkel,et al.  Hypercalcemia associated with increased serum calcitriol levels in three patients with lymphoma. , 1984, Annals of internal medicine.