Estramustine-related hypocalcemia in patients with prostate carcinoma and osteoblastic metastases.
We describe a patient with androgen-independent prostate cancer in whom hypocalcemia developed during treatment with estramustine. The patient's total serum calcium level before and after the initiation of estramustine was 8.3 and 4.3 mg/dL, respectively (normal range 8.4 to 10.2). This finding prompted us to review the calcium levels in 135 consecutive patients who were also undergoing treatment with a similar estramustine-containing regimen. We found that hypocalcemia had developed in 20% of these patients during treatment. We speculate that estramustine may cause hypocalcemia by inhibiting the mobilization of calcium and the action of the parathyroid hormone in the skeleton.
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Departments of Genitourinary Medical Oncology and Endocrinology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Vassilopoulou Sellin
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D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary*; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects; D001859:Bone Neoplasms / Q000556:secondary*; D004961:Estramustine / Q000009:adverse effects*; D006801:Humans; D006996:Hypocalcemia / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies
D018906:Antineoplastic Agents, Alkylating; D004961:Estramustine; D017430:Prostate-Specific Antigen