Alterations in electrolyte equilibrium in patients with acute leukemia.
OBJECTIVE
A wide array of disturbances in electrolyte equilibrium is commonly seen in patients with acute leukemia (AL). These abnormalities present a potential hazard in these patients, as that of enhancing the cardiotoxic effects of certain chemotherapeutic regimens. The literature dealing with AL-related electrolyte abnormalities and their interactions in leukemic patients was reviewed.


RESULTS
Sources included MEDLINE and EMBASE. The search strategy was based on the combination of 'acute leukemia', 'electrolyte abnormalities', 'acid-base disorders', 'potassium', 'sodium', 'magnesium', 'calcium', and 'phosphorus'. References of retrieved articles were also screened. A decrease in serum potassium, mainly owing to lysozyme-induced tubular damage, appears to be one of the most frequent and potentially hazardous abnormalities. Other clinically significant metabolic perturbations include hyponatremia and hypercalcemia.


CONCLUSIONS
A broad spectrum of electrolyte abnormalities is encountered in the clinical setting of AL, which are related to the disease process per se and/or to the therapeutic interventions. Clinicians should be vigilant for early detection and appropriate management of these disorders before the initiation of chemotherapy regimens as well as during treatment.
Filippatos
Theodosios D
TD
Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece.
Milionis
Haralampos J
HJ
Elisaf
Moses S
MS
D000137:Acid-Base Imbalance / Q000209:etiology / Q000378:metabolism; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use; D006331:Heart Diseases / Q000139:chemically induced; D006801:Humans; D007938:Leukemia / Q000150:complications / Q000188:drug therapy / Q000378:metabolism; D016239:MEDLINE; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000378:metabolism
D000970:Antineoplastic Agents