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Serum electrolyte changes at engraftment time in patients undergoing allogeneichematopoietic stem cell transplantation.

Abstract：

BACKGROUND:Metabolic abnormalities have been reported in patients undergoing hematopoietic stem cell transplantation (HSCT). Potential causes, risk factors and outcomes of electrolyte imbalances have thoroughly been investigated. On HSCT recipients, multiple pathophysiologic contributors are inflicting electrolyte abnormalities, with special attention being paid to engraftment per se as an important contributor. Engraftment contribution to electrolyte imbalances has been reported for hypophosphatemia and for other electrolyte abnormalities in autologous setting. However in the allogeneic setting serum electrolyte level changes and the timing of any probable abnormality are unknown. MATERIAL AND METHODS:We performed a retrospective study in order to evaluate the pattern of phosphorous, magnesium, potassium and uric acid serum changes, timing of any probable abnormality and their possible association with WBC and platelet engraftment in 65 allogeneic HCT recipients from day -9 to +32 after transplantation. Besides we assessed frequency and severity of the abnormalities. RESULTS:We observed a declining pattern of electrolyte concentrations with nadirs antedating WBC and platelet engrafments. Phosphorous and potassium serum changes were correlated with natural logarithm of WBC and platelet level changes. Observed overall incidence of hypophosphatemia (9.2%) and hypomagnesemia (3%) was lower than those previously reported. CONCLUSION:Abnormalities found reflect a combination of pathophysiologic mechanisms. Occurrence of electrolyte nadirs antedating engraftment confirms increased consumption by rapidly replicating cells as a contributor in allogeneic setting and specifies a susceptible period requiring intensive monitoring. Considering high risk patients and managing various organ system complications lower incidence of some electrolyte abnormalities may be observed.

journal_name

Ann Transplant

journal_title

Annals of transplantation

authors

Faghihi T,Iravani M,Shamshiri AR,Hadjibabaie M,Mousavi SA,Alimoghaddam K,Ghavamzadeh A

subject

Has Abstract

pub_date

2009-07-01 00:00:00

pages

51-7

issue

eissn

1425-9524

issn

2329-0358

pii

891822

journal_volume

pub_type

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Serum electrolyte changes at engraftment time in patients undergoing allogeneichematopoietic stem cell transplantation.