Hypercalcemia in onco-hematology patients

Abstract

Hypercalcemia is a common event in onco-hematology patients. Mostly reflecting an advanced tumor disease, it may be responsible for multiple organ failure, including neurological and renal failure requiring an early management. The mechanisms associated with hypercalcemia in this context are paraneoplastic secretion of circulating factors (PTH-rp, 1.25 (OH) vitamin D and rarely PTH) and local osteolysis due to bone metastasis. However, the search for non-neoplastic causes remains essential. Treatment relies on volume repletion, bisphosphonates, and the treatment of an underlying malignancy. To date, there is no consensus on the definition of severe forms requiring admission to intensive care and therapeutic management. New studies are needed to better identify patients who are likely to benefit from intensive care unit admission.