Vincristine Toxicity with Hyponatremia and Hypochloremia in an Adult

Wd, Meriwether

doi:10.1159/000224573

Cited by 8 publications

(3 citation statements)

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“…Hyponatremia commonly occurs after a delay of 1-2 weeks following the injection of the drug and lasts for about 2 weeks [45] (Table 1). It is frequently preceded by neurological symptoms not directly related to hyponatremia, such as paralytic ileus or paresthesias [12,25,44,55,60,62,68,75,76,81]. Normalization of hyponatremia of longer duration, up to 25-30 days, can be observed with vinblastine [25].…”

Section: Vinca Alkaloidsmentioning

confidence: 99%

“…The route of administration of the drugs is classically intravenous but in three patients, hepatic arterial infusion of vinblastine was associated with the occurrence of SIADH [21]. The cases described are generally reversible, both for hyponatremia and for its associated symptoms [1,12,17,25,44,52,55,60,62,63,71,76,80,81], but not in every case. One case of a 6-month-old boy treated with vincristine, Adriamycin and cytarabine was fatal in the context of a SIADH.…”

Section: Vinca Alkaloidsmentioning

confidence: 99%

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Hyponatremia related to medical anticancer treatment

Berghmans

1996

Support Care Cancer

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Hyponatremia is a common potential complication in cancer patients. It can be related to anticancer medical therapy. Vincristine, vinblastine, cisplatin and cyclophosphamide are the chemotherapeutic agents most frequently associated with hyponatremia. More recently, analogs such as carboplatin and ifosfamide have also been incriminated. Hyponatremia is also associated with new immunomodulators (interferon, interleukin-2 and levamisole) and monoclonal antibodies. The mechanism by which all these drugs act on the sodium steady state is only partially known. The syndrome of inappropriate antidiuretic hormone secretion is described secondary to vinca alkaloids and cisplatin and possibly with alkylating agents. Renal salt wasting is described with platinum compounds.

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Section: Vinca Alkaloidsmentioning

confidence: 99%

Section: Vinca Alkaloidsmentioning

confidence: 99%

Hyponatremia related to medical anticancer treatment

Berghmans

1996

Support Care Cancer

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“…This is the commonest electrolyte abnormality in AML but it has received very little notice in the literature. Various reports in the past considered a low serum Na+ level as a part of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), and attributed it to Vincristine (Haggard et al, 1968;Meriwether, 1971;Cutting, 1971;Stuart et al, 1975) and to 'cyclophosphamide (DeFronzo et al, 1974). Rodriguez ct a2 (1970) observed hyponatraemia in lfkbrile leukaemic patients after treatment with polymyxin sulphate.…”

Section: Hyponatraemiamentioning

confidence: 99%

Metabolic Disorders in Acute Myeloid Leukaemia

Delamore

1978

Br J Haematol

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Metabolic balance studies were carried out in 17 unselected patients with acute myeloid leukaemia. Widespread metabolic disturbances were observed. Serum Na fell below 135 mmol/1 in 14 patients (82%) and 11 patients (64%) developed hypokalaemia. An increased osmolal clearance caused by a release of electrolyte and blast cell waste (i.e. urea, urate, etc.) during chemotherapy appeared to be the principle cause of natriuresis and hyperkaluria. Seven patients had proteinuria before and eight others developed it during antileukemic therapy. Nine patients (53%) developed proximal renal tubular dysfunction with aminoaciduria, hyperphosphaturia and incomplete reabsorption of urate. No significant relation was found between this widespread glomerulo-tubular dysfunction and lysozymuria. We suggest that antileukaemic drugs release unidentified substances from blast cells which are toxic to the kidney. Metabolic alkalosis in six patients (35%) was probably related to volume depletion and hypokalaemia, while two patients developed acidaemia with the onset of renal failure. Hypocalcemia in seven patients (41%) had a multifactorial basis: hyperphosphaturia, septicaemia, malnutrition and cytotoxic drugs were among the probable causes.

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The development of hyponatremia following combination chemotherapy for metastatic germ cell tumors

Ginsberg

Comis

Miller

1982

Med. Pediatr. Oncol.

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The combination of high dose vinblastine, cisplatin, and bleomycin is an extremely effective, but potentially quite toxic, program for the treatment of metastatic germ cell tumors. In addition to the well-described toxicities, we have noted moderate to severe hyponatremia associated with these drugs. Twelve patients who were receiving this combination chemotherapy program had serum electrolyte levels, plasma osmolality, and creatinine clearance performed prior to and again 5 to 9 days after chemotherapy. Nine of the patients had standard water load tests prior to and again 6 to 15 days after chemotherapy. All 12 patients developed a fall in serum sodium concentrations following chemotherapy, and four patients had severe symptoms attributable to the hyponatremia. Eight patients also developed hypoosmolality suggesting that the hyponatremia was secondary to impaired water handling. In five patients further evidence of impaired water handling was documented by the development of an abnormal standard water load test following chemotherapy. The hyponatremia and impaired water handling may be due primarily to the high doses of vinblastine in the chemotherapeutic program. Patients who are receiving this combination chemotherapy program should be observed for the development of hyponatremia. The presence of severe, symptomatic hyponatremia and impaired water handling may require appropriate treatment including water restriction and hypertonic saline administration.

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Vincristine Toxicity with Hyponatremia and Hypochloremia in an Adult

Cited by 8 publications

References 3 publications

Hyponatremia related to medical anticancer treatment

Hyponatremia related to medical anticancer treatment

Metabolic Disorders in Acute Myeloid Leukaemia

The development of hyponatremia following combination chemotherapy for metastatic germ cell tumors

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