Zekri J, Cheah N L, Evans L, Hancock B
Department of Oncology, King Faisal Specialist Hospital and Research Centre, PO Box 40047, Jeddah 21499, MBC # J-64, Kingdom of Saudi Arabia.
J R Coll Physicians Edinb. 2009 Dec;39(4):301-6. doi: 10.4997/JRCPE.2009.403.
Etoposide, methylprednisolone, cytarabine and cisplatin (ESHAP) is one of the mostly widely used chemotherapy regimens for patients with relapsed lymphomas. Cisplatin administration is commonly associated with electrolyte imbalance. Careful monitoring of renal function and serum electrolytes is therefore essential in this setting.
To review the practice of electrolyte monitoring - potassium (K), calcium (Ca) and magnesium (Mg) - in patients receiving ESHAP and the frequency and severity of abnormalities and their management.
Twenty-one consecutive patients received ESHAP. The medical records of 16 patients were retrievable and reviewed retrospectively. Results of serum K, Ca and Mg were collected prior to and after cycles 1, 2 and 3 of ESHAP, if measured.
Serum K levels prior to every cycle did not show any noticeable change. The means were 4.42, 4.34 and 4.43 mmol/l before cycles 1, 2 and 3, respectively. In one patient hypokalaemia was severe, refractory and symptomatic when preceded by hypomagnesaemia. Serum-adjusted calcium levels showed only minimal reduction. The means were 2.46, 2.40 and 2.38 mmol/l before cycles 1, 2 and 3 respectively. Mean serum Mg levels prior to every cycle showed progressive reduction; 0.84, 0.75 and 0.67 mmol/l before cycles 1, 2 and 3, respectively. This was associated with a progressive increase in the amount of required Mg supplementation. Serum K, Ca and Mg was measured prior to 100%, 67% and 35% of administered cycles, respectively.
In patients receiving ESHAP, hypokalaemia can occasionally be seen, especially if preceded by hypomagnesaemia. Mild cumulative hypocalcaemia is recognised. Hypomagnesaemia is a progressive complication and physicians need be aware of its importance. alcaemia is recognised. Hypomagnesaemia is a progressive complication and physicians need be aware of its importance.
依托泊苷、甲泼尼龙、阿糖胞苷和顺铂（ESHAP）是复发淋巴瘤患者最常用的化疗方案之一。顺铂给药通常与电解质失衡有关。因此，在这种情况下，仔细监测肾功能和血清电解质至关重要。
回顾接受ESHAP治疗患者的电解质监测情况——钾（K）、钙（Ca）和镁（Mg）——以及异常情况的频率和严重程度及其管理。
连续21例患者接受ESHAP治疗。回顾性检索并审查了16例患者的病历。如果进行了测量，则收集ESHAP第1、2和3周期前后的血清钾、钙和镁结果。
每个周期前血清钾水平均未显示出明显变化。第1、2和3周期前的平均值分别为4.42、4.34和4.43 mmol/L。1例患者在低镁血症之前出现严重、难治性且有症状的低钾血症。血清校正钙水平仅略有降低。第1、2和3周期前的平均值分别为2.46、2.40和2.38 mmol/L。每个周期前的平均血清镁水平呈逐渐下降趋势；第1、2和3周期前分别为0.84、0.75和0.67 mmol/L。这与所需镁补充量的逐渐增加有关。分别在100%、67%和35%的给药周期前测量血清钾、钙和镁。
在接受ESHAP治疗的患者中，偶尔会出现低钾血症，尤其是在低镁血症之前。轻度累积性低钙血症是公认的。低镁血症是一种进行性并发症，医生需要意识到其重要性。低钙血症是公认的。低镁血症是一种进行性并发症，医生需要意识到其重要性。
