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Sevelamer hydrochloride: A novel treatment of hyperphosphatemia associated with tumor lysis syndrome in children
Author(s) -
Abdullah Shaker,
Diezi Manuel,
Sung Lillian,
Dupuis L. Lee,
Geary Denis,
Abla Oussama
Publication year - 2008
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21478
Subject(s) - sevelamer , hyperphosphatemia , medicine , tumor lysis syndrome , phosphate binder , gastroenterology , urology , surgery , chemotherapy , kidney disease
Background Sevelamer is a phosphate‐binder used effectively for the treatment of hyperphosphatemia in patients treated with dialysis. Objectives To describe the safety of sevelamer in children with hyperphosphatemia secondary to tumor lysis syndrome and the serum phosphate concentrations observed following its administration. Procedure 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. Pediatr Blood Cancer 2008;51:59–61. © 2008 Wiley‐Liss, Inc.