Sakurada Hiroaki, Kawase Yoji, Mizuno Hidekazu, Naito Kazuyuki, Yamamura Masumi
Dept. of Pharmacy, Ichinomiya Municipal Hospital.
Gan To Kagaku Ryoho. 2018 Sep;45(9):1369-1371.
A man in his 50s with small cell lung cancer received amrubicin as the fourth-line therapy from August 201X-1. Serum phosphorus levels before treatment were normal at 2.9mg/dL, but grade 2 hypophosphatemia(2.1mg/dL)was observed at the beginning of the 2nd course. He underwent laryngoplasty after the 4th course. Retreatment was initiated in June 201X due to disease progression. After reinitiating treatment, the disease developed to grade 3 hypophosphatemia. As we identi- fied lower levels(1.1mg/dL)at the start of the 10th course, a pharmacist proposed oral phosphate therapy to the attending physician, which we administered. After then, the levels improved to 2.2mg/dL; thus, oral phosphate therapy was interrupted. However, because of a decline in serum phosphorus levels to grade 3, we administered the therapy again, and observed favorable improvement. For hypophosphatemia in this case, general reasons in clinical practice were not applicable; thus, amrubicin is considered to be a most possible cause.
一名50多岁的小细胞肺癌男性患者于201X年8月1日接受氨柔比星作为四线治疗。治疗前血清磷水平正常，为2.9mg/dL，但在第2疗程开始时观察到2级低磷血症（2.1mg/dL）。他在第4疗程后接受了喉成形术。由于疾病进展，于201X年6月重新开始治疗。重新开始治疗后，疾病发展为3级低磷血症。在第10疗程开始时我们发现磷水平更低（1.1mg/dL），一名药剂师向主治医生建议进行口服磷酸盐治疗，我们实施了该治疗。此后，磷水平升至2.2mg/dL；因此，中断了口服磷酸盐治疗。然而，由于血清磷水平降至3级，我们再次进行了该治疗，并观察到情况得到了良好改善。对于该病例中的低磷血症，临床实践中的常见原因并不适用；因此，氨柔比星被认为是最有可能的病因。
