Hypophosphatemia and hypouricemia in pediatric allogeneic bone marrow transplant recipients.
Increased phosphate (P) uptake by the replicating neutrophils during engraftment syndrome has been described to play a role in the development of hypophosphatemia (HP) in bone marrow transplantation patients, and suggested as a measure of neutrophil recovery. Here, the relationship of serum P with engraftment was determined in 56 children who underwent allogeneic bone marrow transplantation (BMT). Uric acid (UA) levels were also analyzed to study the contribution of cytolysis on P levels. HP and hypouricemia (HU) developed at least once in 63 and 57% of patients respectively, before and until day +20 after transplantation. The minimal values of P and UA were observed at day +10 and were significantly lower than the baseline values (p < 0.01). The mean neutrophil engraftment was at day +13, following the P and UA nadir by 3 days. In addition there was a significant correlation between P and UA levels (p = 0.01). The levels of of both P and UA returned to pretransplant values at day +20. A significant correlation (p < 0.05) between platelet engraftment and P levels was also demonstrated. HP and HU seen in pediatric patients undergoing BMT reflects a combination of pathophysiologic mechanisms.
Uçkan
Duygu
D
Bone Marrow Transplantation Unit, Ihsan Dogramaci Children's Hospital, Hacettepe University, Ankara, Turkey. duckan@hacettepe.edu.tr
Cetin
Mualla
M
Dida
Abdi
A
Batu
Abdulselam
A
Tuncer
Murat
M
Tezcan
Ilhan
I
D000293:Adolescent; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D017674:Hypophosphatemia / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D014527:Uric Acid / Q000652:urine*
D014527:Uric Acid