Hypomagnesemia– A Toxicity of Platinum Co-Ordination Compounds
Journal of Medical Science And clinical Research
Hypomagnesemia is a know side effect of platinum coordination complexes (cisplatin, carboplatin and oxaliplatin) which have revolutionised the treatment of many human cancers. The objective of the study was to determine association of hypomagnesemia with platinum based chemotherapy and to study the association of hypomagnesemia with hypocalcemia and hypomagnesemia with hypokalemia. 70 newly diagnosed cancer patients who were put on combination chemotherapy were evaluated for various electrolyte
... various electrolyte abnormalities during chemotherapy and were subsequently followed at six monthly intervals for a period of 18 months to ascertain any improvrment or persistence of dyselectrolytemias.we found that among the 70 patients studied, 42 patients received a cisplatin based chemotherapy; 7 received carboplatin based chemotherapy and 21 received oxaliplatin based chemotherapy. Cisplatin was the most nephrotoxic among the three with hypomagnesemia occurring in 87.5% of cases. Serum magnesium fell sequentially from pre-treatment value from 0.9±0.2mg/dl to 0.61±0.17 mg/dl at sixth cycle. Hypomagnesia persisted in 23 of 35 patients at follow up. Hypocalcemia and hypokalemia both occurred in the presence of hypomagnesemia. Hypokalemia occurred more frequently than hypocalcemia in cisplatin group. Electrolyte abnormalities were less common with carboplatin and oxaliplatin. Our study indicated that hypomagnesemia occurs sequentially and commonly with platinum based chemotherapy despite corrective measures. A strong association (p<0.05) is seen between hypomagnesemia with hypocalcemia and hypomagnesemia with hypokalemia. There is persistence of electrolyte disturbances even after discontinuation of chemotherapy which makes continous monitoring and replacement mandatory.