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2016 ; 32
(1
): 78-82
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Sevelamer is an Effective Drug in Treating Hyperphosphatemia Due to Tumor Lysis
Syndrome in Children: A Developing World Experience
#MMPMID26855510
Kahlon DK
; Dinand V
; Yadav SP
; Sachdeva A
Indian J Hematol Blood Transfus
2016[Mar]; 32
(1
): 78-82
PMID26855510
show ga
We report here a study on efficacy of sevelamer hydrochloride in treating
hyperphosphatemia due to tumor lysis syndrome (TLS) in a developing world
setting. Twenty one children with hyperphosphatemia due to TLS were included. All
received hyper-hydration, allopurinol and sevelamer. Efficacy was assessed by
decrease in serum phosphate level, calcium-phosphate product and TLS score as per
Cairo Bishop definition. Four children who underwent dialysis were excluded from
analysis. Among the remaining 17 patients with hyperphosphatemia, laboratory TLS
was recorded in 15 patients and clinical TLS in five. Sevelamer was given
according to weight, most often 400 mg twice to thrice daily. Mean phosphatemia
decreased from 8.3 ± 3.0 to 6.7 ± 2.1 mg/dl within 24 h of starting sevelamer
(p = 0.02), 6.0 ± 2.1 mg/dl at 48 h, 4.9 ± 1.5 mg/dl at 72 h and 4.39 ± 1.7 mg/dl
at 96 h. TLS was corrected in 72 h in 14 patients, 96 h in 1 and 120 h in another
patient. Mean calcium-phosphate product decreased from 63.0 ± 14.0 to
49.2 ± 9.7 mg/dl (p = 0.002) at 24 h, 46.1 ± 17.0 mg/dl at 48 h and
39.7 ± 13.5 mg/dl at 72 h. There was no mortality due to hyperphosphatemia.
Sevelamer is efficacious in children with malignancy-associated hyperphosphatemia
in the developing world.