Sevelamer hydrochloride: A novel treatment of hyperphosphatemia associated with tumor lysis syndrome in children

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% Cl, 1.7-3.1) to 1.1 mmol/L +/- 0.2 at hour 72 (95%Cl, 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.

5-7-19, réception du maréchal Pétain à l'Académie des sciences : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 54728

5-7-19, réception du maréchal Pétain à l'Académie des sciences : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 54723

5-7-19, réception du maréchal Pétain à l'Académie des sciences : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 54722

Parc des Princes, 27/7/19, tour d'honneur de [Firmin] Lambot vainqueur du Tour de France : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 55182

Parc des Princes, 27/7/19, [Firmin] Lambot vainqueur du Tour de France : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 55180

Parc des Princes, 27/7/19, arrivée du Tour de France, en tête [Jean] Alavoine, [Luigi Natale] Lucotti, [Honoré] Barthélémy : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 55179

Parc des Princes, 27/7/19, [Jean] Alavoine 2e du classement du Tour de France : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 55185

Mme Susset [du club Les Mouettes de Paris, 27/7/19, championnat de Paris, natation, Choisy-le-Roi] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 55191

Mme Decorne [du club Les Mouettes de Paris, 27/7/19, championnat de Paris, natation, Choisy-le-Roi] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 55190

27/7/19 [illisible, championnat de Paris, natation, Choisy-le-Roi] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 55189

Parc des Princes, 27/7/19, [Jean] Alavoine 2e du classement du Tour de France, gagnant [de la] dernière étape : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 55186

4-7-19, stade Pershing, arrivée du marathon [modifié des Jeux interalliés, Jean Vermeulen coupe la ligne d'arrivée, le n°971 Armando Pagliani et le n°1280 Alphonse Van Hoey sont distancés] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 54715

4-7-19, stade Pershing, marathon [modifié des Jeux interalliés, Jean Vermeulen devant Fred Faller] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 54714

Sevrage éthylique inhabituel et compliqué: avez-vous vérifié la phosphatémie [Unusual alcoholic weaning, complicated: do you check the blood phosphate?].

A 65 year old alcoholic man was hospitalized because he was tired, hypotonic, with postural tremor. The neurologic symptoms increased during the first two days despite an adequate therapy for alcoholic weaning with hydratation, benzodiazepines and vitamins. A severe hypophosphatemia is diagnosed, associated with hypovitaminosis D, mild hypomagnesemia, mild hypokaliemia and a refeeding syndrome. 24 hours after the normalisation of his phosphatemia, the neurologic symptoms are adjusted.