Antineoplastics
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Reactions 1347 - 16 Apr 2011 S Antineoplastics Hypocalcaemia?: case report A 90-year-old man was diagnosed with Hodgkin’s lymphoma and developed hypocalcaemia during treatment with an AVD chemotherapy regimen. He was later switched to ACOPP chemotherapy and his hypocalcaemia worsened [routes and dosages not stated]. The man received AVD chemotherapy, composed of doxorubicin [adriamycin], vinblastine and dacarbazine. After 3 weeks his calcium levels, which had been normal at the time of his diagnosis, were below normal. He received calcium gluconate and calcium carbonate and his serum calcium levels improved slightly. He completed 3 cycles of AVD and was then managed conservatively. His hypocalcaemia was less severe, but persisted. About 9 months after his lymphoma was diagnosed, he progresed. ACOPP chemotherapy with doxorubicin, cyclophosphamide, vinblastine, procarbazine and prednisolone was initiated and his calcium levels fell again. He was asymptomatic, and was treated with calcitrol and an increased calcium intake. His intact parathyroid hormone level was low-normal, and increased after chemotherapy completion. He was subsequently hospitalised with muscle weakness, and repeated calcium repletion was only minimally effective. Further investigation revealed a mild decrease in magnesium levels which was also resistant to treatment. ACOPP was withdrawn after 4 cycles and he continued to receive calcitrol. His ionized calcium level normalised 10 months after the end of chemotherapy. Author comment: The man had "normocalcemia before receiving chemotherapy, with a substantial decrease within 3 weeks after receiving AVD. . . Direct suppression of parathyroid hormone or altered calcium sensing by chemotherapeutic agents may be the cause, although the precise mechanism of the possible hypocalcemic effect could not be determined in our patient." Ajero PME, et al. Chemotherapy-induced hypocalcemia. Endocrine Practice 16: 284-290, No. 2, Mar-Apr 2010. Available from: URL: http://dx.doi.org/10.4158/ ep09137.ra - USA 803053108 1 Reactions 16 Apr 2011 No. 1347 0114-9954/10/1347-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1347 - 16 Apr 2011
SAntineoplastics
Hypocalcaemia?: case reportA 90-year-old man was diagnosed with Hodgkin’s
lymphoma and developed hypocalcaemia during treatmentwith an AVD chemotherapy regimen. He was laterswitched to ACOPP chemotherapy and his hypocalcaemiaworsened [routes and dosages not stated].
The man received AVD chemotherapy, composed ofdoxorubicin [adriamycin], vinblastine and dacarbazine.After 3 weeks his calcium levels, which had been normal atthe time of his diagnosis, were below normal.
He received calcium gluconate and calcium carbonateand his serum calcium levels improved slightly. Hecompleted 3 cycles of AVD and was then managedconservatively. His hypocalcaemia was less severe, butpersisted.
About 9 months after his lymphoma was diagnosed, heprogresed. ACOPP chemotherapy with doxorubicin,cyclophosphamide, vinblastine, procarbazine andprednisolone was initiated and his calcium levels fell again.He was asymptomatic, and was treated with calcitrol andan increased calcium intake. His intact parathyroidhormone level was low-normal, and increased afterchemotherapy completion. He was subsequentlyhospitalised with muscle weakness, and repeated calciumrepletion was only minimally effective. Furtherinvestigation revealed a mild decrease in magnesium levelswhich was also resistant to treatment. ACOPP waswithdrawn after 4 cycles and he continued to receivecalcitrol. His ionized calcium level normalised 10 monthsafter the end of chemotherapy.
Author comment: The man had "normocalcemia beforereceiving chemotherapy, with a substantial decrease within3 weeks after receiving AVD. . . Direct suppression ofparathyroid hormone or altered calcium sensing bychemotherapeutic agents may be the cause, although theprecise mechanism of the possible hypocalcemic effect couldnot be determined in our patient."Ajero PME, et al. Chemotherapy-induced hypocalcemia. Endocrine Practice 16:284-290, No. 2, Mar-Apr 2010. Available from: URL: http://dx.doi.org/10.4158/ep09137.ra - USA 803053108
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Reactions 16 Apr 2011 No. 13470114-9954/10/1347-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
