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Hypercalcemia of Malignancy: Treatment with Intravenous Dichloromethylene Diphosphonate

THOMAS P. JACOBS, M.D.; ETHEL S. SIRIS, M.D.; JOHN P. BILEZIKIAN, M.D.; DELIA C. BAQUIRAN, M.S.N.; ELIZABETH SHANE, M.D.; and ROBERT E. CANFIELD, M.D.
[+] Article and Author Information

Grant support: by grants AM 09579 and RR 00654 and training grant T32 AM 07271 from the National Institutes of Health. Dr. Bilezikian is the recipient of Research Career Development Award HL 00383 from the National Institutes of Health. Proctor and Gamble Company provided partial support of technical services.

This work was presented in part at the Second Annual Meeting of the American Society for Bone and Mineral Research, June 1980, in Washington, D.C.

▸Requests for reprints should be addressed to Thomas P. Jacobs, M.D.; Department of Medicine, College of Physicians & Surgeons, Room 8-436, 630 West 168th Street; New York, NY 10032.


New York, New York


© 1981 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1981;94(3):312-316. doi:10.7326/0003-4819-94-3-312
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Twelve patients with hypercalcemia associated with various malignancies were treated with intravenous dichloromethylene diphosphonate (Cl2MDP), a potent inhibitor of osteoclastic bone resorption, in doses of 2.5 mg/kg of body weight initially and 5.0 mg/kg thereafter for up to 7 days. Mean serum calcium concentration fell from 13.8 ± 0.6 mg/dL (SEM) before Cl2MDP to 9.8 ± 0.7 mg/dL (SEM) (p < 0.001) after 7 days. Urine calcium excretion fell from 775 ± 95 mg/g creatinine (SEM) to 272 ± 70 mg/g creatinine (SEM) (p < 0.005), and urine hydroxyproline excretion fell from 144 ± 28 mg/g creatinine (SEM) to 78 ± 18 mg/g creatinine (SEM) (p < 0.05) after treatment with Cl2MDP. The Cl2MDP was well tolerated, and adverse effects were limited to asymptomatic hypocalcemia in two patients. The ability of Cl2MDP to correct hypercalcemia and reduce urine calcium and hydroxyproline excretion in these patients is consistent with the hypothesis that increased bone resorption is primarily responsible for this complication of malignancy and suggests that Cl2MDP may be highly useful in managing this condition.

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