Evaluating the impact of high calcium levels on patient outcomes in diffuse large B-cell lymphoma

This study investigated the impact of high levels of calcium in the blood on the outcomes of patients with diffuse large B-cell lymphoma (DLBCL). This study concluded that this condition is common patients with DLBCL and can lead to poorer outcomes.

About 25% of patients with cancer develop hypercalcemia (HC). This means that they have high levels of calcium in their blood. HC can come from the cancer itself or from a condition called hyperparathyroidism. This condition is characterized by high levels of a hormone in the blood called parathyroid hormone (PTH). High levels of this hormone can lead to high levels of calcium as well.

HC has been associated with poor outcomes for patients with cancer. Previous research has shown that multiple myeloma is the most common type of cancer associated with HC. However, how common HC is among patients with DLBCL is unknown. The outcomes of patients with DLBCL and HC remain under investigation.

This study had 250 patients with newly diagnosed DLBCL. 18% (46 patients) had HC. Of these, this condition was cancer-related in 15 patients and parathyroid-related in 12 patients. An additional 46 patients with normal calcium levels were also included in this study (control group).

Overall, 78% of patients responded to first-line anti-cancer therapy. Slightly more patients with normal calcium levels responded to treatment compared to patients with high levels (83% vs. 74%). In both groups, 72% of patients had a complete disappearance of all signs of cancer.

On average, patients with HC survived for an average of 28 months. Patients with normal calcium levels survived for longer on average without tumor growth or spread compared to patients with high levels (42 months vs. 28 months).

In a separate analysis, cancer-related HC (15 patients) was compared to parathyroid-related HC (12 patients). On average, patients with high calcium levels due to cancer had a significantly shorter survival (14 months vs. not reached). Average survival without tumor growth or spread was also significantly shorter in patients with HC (13 months vs. not reached).

This study concluded that hypercalcemia is common in patients with DLBCL. The authors suggest that high calcium levels associated with lymphoma may be associated with poorer long-term outcomes.

This study was retrospective, meaning it looked back in time to analyze data. Also, information about PTH levels was only available for 27 patients with high calcium levels. This may limit the conclusions that can be drawn from these results. More studies with larger patient populations are needed to confirm these results.