title: Sevelamer hydrochloride: a novel treatment of hyperphosphatemia associated with tumor lysis syndrome in children.
abstract: BACKGROUND
  Sevelamer is a phosphate-binder used effectively for the treatment of hyperphosphatemia in patients treated with dialysis.
  
  
  OBJECTIVE
  To describe the safety of sevelamer in children with hyperphosphatemia secondary to tumor lysis syndrome and the serum phosphate concentrations observed following its administration.
  
  
  METHODS
  A retrospective chart review of all children with leukemia/lymphoma diagnosed between November 2002 and April 2004 who received sevelamer during their initial admission was conducted. We monitored the effects of sevelamer on serum phosphate concentration, calcium/phosphate product and renal function at hours 24, 48, and 72 from sevelamer initiation.
  
  
  RESULTS
  Thirteen patients received sevelamer during the study period. Their median age was 13 years (range 2.7-17.9) and eight were boys. Nine children had acute lymphoblastic leukemia, one had acute myeloid leukemia and 3 had non-Hodgkin's lymphoma. The most frequently used dose of sevelamer was 400 mg orally twice daily. The median duration of sevelamer therapy was 2 days (range 1-7). Two children were excluded from the efficacy analysis due to concurrent use of dialysis. Mean serum phosphate levels decreased after sevelamer administration, in eleven patients, from a baseline 2.2 mmol/L +/- 0.4 (95% CI, 1.7-3.1) to 1.1 mmol/L +/- 0.2 at hour 72 (95%CI, 0.6-1.5). The only toxicity attributed to sevelamer was mild vomiting in three patients.
  
  
  CONCLUSIONS
  Sevelamer appears to be effective and tolerable for the treatment of hyperphosphatemia associated with tumor lysis syndrome.
authors.affiliation: Divisions of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Shaker
authors.initials: S
authors.lastname: Abdullah
authors.forename: Manuel
authors.initials: M
authors.lastname: Diezi
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
authors.forename: L Lee
authors.initials: LL
authors.lastname: Dupuis
authors.forename: Denis
authors.initials: D
authors.lastname: Geary
authors.forename: Oussama
authors.initials: O
authors.lastname: Abla
mesh_terms: D000293:Adolescent; D002130:Calcium Phosphates / Q000097:blood; D002614:Chelating Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D054559:Hyperphosphatemia / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D010710:Phosphates / Q000097:blood; D011073:Polyamines / Q000008:administration & dosage* / Q000633:toxicity; D012189:Retrospective Studies; D000069603:Sevelamer; D016896:Treatment Outcome; D015275:Tumor Lysis Syndrome / Q000150:complications* / Q000188:drug therapy; D014839:Vomiting / Q000139:chemically induced
chemical_list: D002130:Calcium Phosphates; D002614:Chelating Agents; D010710:Phosphates; D011073:Polyamines; C020243:calcium phosphate; D000069603:Sevelamer