Myelofibrosis, Osteolytic Bone Lesions and Hypercalcemia in Chronic Myeloid Leukemia

A patient with chronic myeloid leukemia of 5 years duration developed myelofibrosis shortly before death. Severe destructive bone lesions were found preterminally in the femur, ribs, pelvis and skull. Hypercalcemia of 14.2 mg%was present as well. Although the serum calcium level was reduced by treatment to 11.5 mg%, the patient died in renal failure and pulmonary infection shortly thereafter. Hypercalcemia with its clinical implications should be suspected in the presence of myelofibrosis and bone pain complicating chronic myeloid leukemia.