A rare case of Acute Lymphoblastic Leukemia related to Hypercalcemia

Hypercalcemia is a rare complication in Acute Lymphoblastic Leukemia (ALL), especially in adults, often associated with severe progression. We report a case of a 58-year-old male with B-cell ALL, initially presenting with thrombocytopenia and hypercalcemia. Molecular testing, including BCR-ABL, FLT3, NPM1, and JAK2 mutations, was negative, with a normal karyotype, leaving hypercalcemia and age as poor prognostic factors. The patient received HYPER-CVAD without remission and, subsequently, the FLAG-Ida protocol, resulting in septic shock and a fatal outcome. This case highlights the challenges in managing ALL with hypercalcemia without typical high-risk genetic markers.