1987 Volume 28 Issue 2 Pages 228-232
A patient with chronic myeloid leukemia in blast crisis accompanied with severe hypophosphatemia was reported. Hypophosphatemia showed a direct relationship with an increase of tumor cells.
The patient was a 52-year-old man with Ph1-positive chronic myeloid leukemia. On admission the WBC count was 101,400/μl with 6% of blasts, serum phosphorus and calcium levels were normal. After chemotherapy the WBC count decreased to lower than 10,000/μl. 11 days after discontinuation of the chemotherapy, a rise in number of the WBC was observed. Within a few days the WBC count increased to more than 200,000/μl with 40∼70% of blasts. The serum phosphorus level fell to 0.2 mg/dl and urinary excretion of phosphorus was 9∼12 mg/day. Serum calcium level was normal. Severe hypophosphatemia was not corrected by intravenous administration of phosphate, but serum concentration and urinary excretion of phosphorus increased following chemotherapy. On the fifth day of chemotherapy the patient died because of progressive respiratory failure. At autopsy leukemic cells diffusely infiltrated in bone marrow, liver, spleen and other main organs.
It was suggested that marked hypophosphatemia observed in this case may be caused by a shift of extracellular phosphorus into rapidly proliferating tumor cells.
