Hypercalcemia complicating leukemic transformation of agnogenic myeloid metaplasia-myelofibrosis

Hypercalcemia is a common and potentially life-threatening metabolic derang ement associated with many malignancies, especially solid tumors and multip le myeloma. Hypercalcemia has been reported only rarely with acute myelogen ous leukemia. We describe a patient who developed hypercalcemia in associat ion with transformation of agnogenic myeloid metaplasia into M7 acute myelo genous leukemia. Laboratory investigation revealed low levels of serum para thyroid hormone, undetectable levels of parathyroid hormone-related peptide , and normal levels of 25-hydroxyvitamin D. These observations suggest that another mediator was responsible for hypercalcemia in this patient. Awaren ess of this rare complication of acute myelogenous leukemia is essential fo r prompt diagnosis and management.