Vol 9, No 1 (2018)
Review paper
Published online: 2018-05-23
Metabolic and water-electorlyte homeostasis disorders in patients with hematologic malignancies
Hematologia 2018;9(1):22-37.
Abstract
Metabolic and water-electrolyte disorders occur in hematologic malignancies and arise from the disease itself as well as anti-cancer treatment. The most common metabolic and electrolyte complications include: hyperuricemia and tumor lysis syndrome, hyperammonemia, metabolic acidosis, syndrome of inappropriate antidiuretic hormone, hyponatremia, hypercalcemia, hypokalemia and disorders of carbohydrate metabolism. Co-morbidities, performance status of the patient, type of causative and supportive treatment may contribute to disturbing the metabolic balance of the patient. The article discusses the most common causes of these disorders, their symptoms and treatment.
Keywords: metabolic disorderswater-electrolyte homeostasis disturbanceshematological malignanciestreatment
References
- Spinazzé S, Schrijvers D. Metabolic emergencies. Crit Rev Oncol Hematol. 2006; 58(1): 79–89.
- Carella AM, Marinelli T, Di Pu, et al. Metabolic disorders in elderly patients with hematologic malignancies. World J Oncol Res. 2015; 2: 28–36.
- Kokot F, Franek E. Zaburzenia gospodarki wodno-elektrolitowej i kwasowo-zasadowej. Wydawnictwo Lekarskie PZWL, Warszawa 2013.
- Lewis II, Roberts KB. Zaburzenia gospodarki wodno-elektrolitowej. In: Beers MH, Porter RS, Jones TV, Kaplan JL, Berkwits M. ed. The Merck Manual podręcznik diagnostyki i terapii. Elsevier Urban&Partner, Wrocław 2008: 1613.
- Żak I. Równowaga wodno-elektrolitowa ustroju. In: Żak I. ed. Chemia Medyczna. Śląska Akademia Medyczna, Katowice 2001: 80.
- Cheuvront SN, Kenefick RW. Dehydration: physiology, assessment, and performance effects. Compr Physiol. 2014; 4(1): 257–285.
- Huang LH, Ellsbury DL, George CS, Anchala KR. Dehydration: Background, Pathophysiology, Epidemiology. http://emedicine.medscape.com/article/906999-overview.
- Gellert R. Signs and symptoms of dehydration in the elderly. Post Nauk Med. 2015; 28: 744–748.
- Thomas DR, Cote TR, Lawhorne L, et al. Dehydration Council. Understanding clinical dehydration and its treatment. J Am Med Dir Assoc. 2008; 9(5): 292–301.
- Braun MM, Barstow CH, Pyzocha NJ. Diagnosis and management of sodium disorders: hyponatremia and hypernatremia. Am Fam Physician. 2015; 91(5): 299–307.
- Spasovski G, Vanholder R, Allolio B, et al. Hyponatraemia Guideline Development Group. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol. 2014; 170(3): G1–47.
- Onitilo AA, Kio E, Doi SAR. Tumor-related hyponatremia. Clin Med Res. 2007; 5(4): 228–237.
- Filippatos TD, Milionis HJ, Elisaf MS. Alterations in electrolyte equilibrium in patients with acute leukemia. Eur J Haematol. 2005; 75(6): 449–460.
- Castillo JJ, Vincent M, Justice E. Diagnosis and management of hyponatremia in cancer patients. Oncologist. 2012; 17(6): 756–765.
- Witek P. Postępy w rozpoznawaniu i leczeniu hiponatremii. Post Nauk Med. 2008; 2: 75–82.
- Liamis G, Milionis H, Elisaf M. A review of drug-induced hyponatremia. Am J Kidney Dis. 2008; 52(1): 144–153.
- Hamdi T, Latta S, Jallad B, et al. Cisplatin-induced renal salt wasting syndrome. South Med J. 2010; 103(8): 793–799.
- Momi J, Tang CM, Abcar AC, et al. Hyponatremia-what is cerebral salt wasting? Perm J. 2010; 14(2): 62–65.
- Krzakowski M. Zespoły paranowotworowe. Pol Med Paliatywna. 2002; 1: 57–66.
- Chamienia A. Gospodarka potasowa — podstawy teoretyczne i codzienna praktyka lekarska . Chor Serca Naczyń. 2004; 1: 97–107.
- Rastegar A, Soleimani M. Hypokalaemia and hyperkalaemia. Postgrad Med J. 2001; 77(914): 759–764.
- Alfonzo AVM, Isles C, Geddes C, et al. Potassium disorders--clinical spectrum and emergency management. Resuscitation. 2006; 70(1): 10–25.
- Perazella MA. Drug-induced hyperkalemia: old culprits and new offenders. Am J Med. 2000; 109(4): 307–314.
- Kim HJ, Han SW, et al. Therapeutic approach to hyperkalemia. Nephron. 2002; 92 Suppl 1: 33–40.
- Kamel KS, Wei C. Controversial issues in the treatment of hyperkalaemia. Nephrol Dial Transplant. 2003; 18(11): 2215–2218.
- Franek E, Kokot F. Hipokaliemia. Chor Serca Naczyń. 2006; 3: 203–206.
- Cohn JN, Kowey PR, Whelton PK, et al. New guidelines for potassium replacement in clinical practice: a contemporary review by the National Council on Potassium in Clinical Practice. Arch Intern Med. 2000; 160(16): 2429–2436.
- Skinner R, Cotterill SJ, Stevens MC. Risk factors for nephrotoxicity after ifosfamide treatment in children: a UKCCSG Late Effects Group study. United Kingdom Children's Cancer Study Group. Br J Cancer. 2000; 82(10): 1636–1645.
- Muggia FM, Heinemann HO, Farhangi M, et al. Lysozymuria and renal tubular dysfunction in monocytic and myelomonocytic leukemia. Am J Med. 1969; 47(3): 351–366.
- Wulf GG, Jahns-Streubel G, Strutz F, et al. Paraneoplastic hypokalemia in acute myeloid leukemia: a case of renin activity in AML blast cells. Ann Hematol. 1996; 73(3): 139–141.
- Gellert R. Hipo- i hiperkalcemia - patogeneza i problemy terapeutyczne. Forum Nefrol. 2011; 4: 373–382.
- Pawlak WZ, Wawrocka-Pawlak M. Hiperkalcemia w chorobie nowotworowej – patofizjologia, diagnostyka, leczenie. Współcz Onkol. 2003; 7: 482–496.
- Carroll MF, Schade DS. A practical approach to hypercalcemia. Am Fam Physician. 2003; 67(9): 1959–1966.
- Nanji AA. Misleading biochemical laboratory test results. Can Med Assoc J. 1984; 130(11): 1435–1441.
- Vassilopoulou-Sellin R, Newman B, Taylor S, et al. Incidence of hypercalcemia in patients with malignancy referred to a comprehensive cancer center. Cancer. 1993; 71(4): 1309–1312, doi: 10.1002/1097-0142(19930215)71:4<1309::aid-cncr2820710423>3.0.co;2-m.
- Nosaka K, Miyamoto T, Sakai T, et al. Mechanism of hypercalcemia in adult T-cell leukemia: overexpression of receptor activator of nuclear factor kappaB ligand on adult T-cell leukemia cells. Blood. 2002; 99(2): 634–640.
- Majumdar G. Incidence and prognostic significance of hypercalcaemia in B-cell non-Hodgkin's lymphoma. J Clin Pathol. 2002; 55(8): 637–638.
- Littlewood TJ, Lydon AP, Barton CJ. Hypercalcemia and osteolytic lesions associated with chronic lymphatic leukemia (CLL). J Clin Pathol. 1990; 43(10): 877.
- Kent AB, Weinstein RS. Case report: hypercalcemia in acute myeloblastic leukemia is caused by osteoclast activation. Am J Med Sci. 1993; 306(3): 169–173.
- Sharma N, Jain S, Kumari S, et al. Hypercalcaemia with radiographic abnormalities in chronic myeloid leukaemia. Postgrad Med J. 1998; 74(871): 301–303.
- Trehan A, Cheetham T, Bailey S. Hypercalcemia in acute lymphoblastic leukemia: an overview. J Pediatr Hematol Oncol. 2009; 31(6): 424–427.
- Smarz-Widelska I, Syroka-Główka M, Książek P, et al. Hiperkalcemia w wybranych przypadkach klinicznych. Nefrol Dial Pol. 2006; 10: 34–37.
- Jakubas-Kwiatkowska W, Błachowicz A, Franek E. Hipokalcemia w praktyce klinicznej — przyczyny, objawy i leczenie. Chor Serca Naczyń. 2005; 2: 232–237.
- Londner M. Gospodarka kwasowo-zasadowa i jej zaburzenia. In: Beers MH, Porter RS, Jones TV, Kaplan JL, Berkwits M. ed. The Merck Manual podręcznik diagnostyki i terapii. Elsevier Urban&Partner, Wrocław 2008: 1650.
- Żak I. Równowaga kwasowo-zasadowa ustroju. In: Żak I. ed. Chemia Medyczna. Śląska Akademia Medyczna, Katowice 2001: 122.
- Sacks GS. The ABC's of Acid-Base Balance. J Pediatr Pharmacol Ther. 2004; 9(4): 235–242.
- Kokot F, Franek E. Zaburzenia równowagi kwasowo-zasadowej. In: Szczeklik A. ed. Choroby wewnętrzne. Medycyna Praktyczna, Kraków 2011: 2302.
- Claudino WM, Dias A, Tse W, et al. Type B lactic acidosis: a rare but life threatening hematologic emergency. A case illustration and brief review. Am J Blood Res. 2015; 5(1): 25–29.
- Cairo MS, Bishop M. Tumour lysis syndrome: new therapeutic strategies and classification. Br J Haematol. 2004; 127(1): 3–11.
- Mirrakhimov AE, Voore P, Khan M, et al. Tumor lysis syndrome: A clinical review. World J Crit Care Med. 2015; 4(2): 130–138.
- Montesinos P, Lorenzo I, Martín G, et al. Tumor lysis syndrome in patients with acute myeloid leukemia: identification of risk factors and development of a predictive model. Haematologica. 2008; 93(1): 67–74.
- Jones GL, Will A, Jackson GH, et al. British Committee for Standards in Haematology. Guidelines for the management of tumour lysis syndrome in adults and children with haematological malignancies on behalf of the British Committee for Standards in Haematology. Br J Haematol. 2015; 169(5): 661–671.
- Coiffier B, Altman A, Pui CH, et al. Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review. J Clin Oncol. 2008; 26(16): 2767–2778.
- Malberti F. Hyperphosphataemia: treatment options. Drugs. 2013; 73(7): 673–688.
- Nayar M, Lombard M, Furlong N, et al. Diagnosis and Management of Nonislet Cell Tumor Hypoglycemia. Endocrinologist. 2006; 16(4): 227–230.
- Halsall DJ, Mangi M, Soos M, et al. Hypoglycemia due to an insulin binding antibody in a patient with an IgA-kappa myeloma. J Clin Endocrinol Metab. 2007; 92(6): 2013–2016.
- Hoogwerf D, van Doorn J, Maartense E. The insulin-like growth factor-system in a patient with diffuse large B-cell non-Hodgkin's lymphoma and lactic acidosis. Ann Clin Biochem. 2013; 50(Pt 2): 169–172.
- Iglesias P, Díez JJ. Management of endocrine disease: a clinical update on tumor-induced hypoglycemia. Eur J Endocrinol. 2014; 170(4): R147–R157.
- Hussain BM, Geetha N, Lali V, et al. Rituximab induced hypoglycemia in non-Hodgkin's lymphoma. World J Surg Oncol. 2006; 4: 89.
- Agostino NM, Chinchilli VM, Lynch CJ, et al. Effect of the tyrosine kinase inhibitors (sunitinib, sorafenib, dasatinib, and imatinib) on blood glucose levels in diabetic and nondiabetic patients in general clinical practice. J Oncol Pharm Pract. 2011; 17(3): 197–202.
- Bay A, Oner AF, Cesur Y, et al. Symptomatic hypoglycemia: an unusual side effect of oral purine analogues for treatment of ALL. Pediatr Blood Cancer. 2006; 47(3): 330–331.
- Nunnari G, Celesia BM, Bellissimo F, et al. Trimethoprim-sulfamethoxazole-associated severe hypoglycaemia: a sulfonylurea-like effect. Eur Rev Med Pharmacol Sci. 2010; 14(12): 1015–1018.
- Parra-Riffo H, Lemus-Peñaloza J. Severe levofloxacin-induced hypoglycaemia: a case report and literature review. Nefrologia. 2012; 32(4): 546–547.
- Pelosof LC, Gerber DE. Paraneoplastic syndromes: an approach to diagnosis and treatment. Mayo Clin Proc. 2010; 85(9): 838–854.
- Davda R, Seddon BM. Mechanisms and management of non-islet cell tumour hypoglycaemia in gastrointestinal stromal tumour: case report and a review of published studies. Clin Oncol (R Coll Radiol). 2007; 19(4): 265–268.
- Bodnar TW, Acevedo MJ, Pietropaolo M. Management of non-islet-cell tumor hypoglycemia: a clinical review. J Clin Endocrinol Metab. 2014; 99(3): 713–722.
- Healy SJ, Dungan KM. Hyperglycemia in patients with hematologic malignancies. Curr Diab Rep. 2015; 15(3): 8.
- Fine P, Adler K, Gerstenfeld D. Idiopathic hyperammonemia after high-dose chemotherapy. Am J Med. 1989; 86(5): 629.
- Ho AY, Mijovic A, Pagliuca A, et al. Idiopathic hyperammonaemia syndrome following allogeneic peripheral blood progenitor cell transplantation (allo-PBPCT). Bone Marrow Transplant. 1997; 20(11): 1007–1008.
- Chen YH, Chiou TJ, Hsu YN, et al. Idiopathic hyperammonemia after chemotherapy with vinorelbine, topotecan, and cisplatin in a patient with acute lymphocytic leukemia. Hematol Oncol Stem Cell Ther. 2010; 3(4): 199–202.
- Nott L, Price TJ, Pittman K, et al. Hyperammonaemic encephalopathy associated with rituximab-containing chemotherapy. Intern Med J. 2008; 38(10): 800–803.
