Abstract
A patient suffering from acute myeloid leukemia (FAB M5a) received a PBSC allograft from a matched, related donor. On day 13 after transplantation severe hypophosphatemia (0.21 mmol/l) was first noted which persisted irrespective of intravenous phosphate administration, and within 2 days reached concentrations below 0.13 mmol/l. After repeated phosphate substitution serum phosphate returned to 1.40 mmol/l on day 17. Phosphate in urine, and calcium in serum were recorded as unchanged throughout. Clinical signs and symptoms due to severe hypophosphatemia were not observed except for paresthesia in the lower extremities. The precipitous fall in serum phosphate coincided with hematopoietic reconstitution as reflected by a steep rise in leukocyte count from 0.08 × 109/l on day 10 to 5.94 × 109/l on day 15 after transplantation. Thus, isolated hypophosphatemia was likely the result of excessive cellular phosphate uptake during hematopoietic reconstitution. Electrolyte monitoring after PBSCT should include serum phosphate to identify the hypophosphatemia associated with hematopoietic recovery. Bone Marrow Transplantation (2000) 25, 1015–1016.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Crook M, Swaminathan R . Disorders of plasma phosphate and indications for its measurement Ann Clin Biochem 1996 33: 376–396
Perreault MM, Ostrop NJ, Tierney MG . Efficacy and safety of intravenous phosphate replacement in critically ill patients Ann Pharmacother 1997 31: 683–688
Zamkoff KW, Kirshner JJ . Marked hypophosphatemia associated with acute myelomonocytic leukemia. Indirect evidence of phosphorus uptake by leukemic cells Arch Intern Med 1980 140: 1523–1524
Young IS, Bailie K, Trimble ER . Severe hypophosphataemia in a patient with acute leukaemia Ann Clin Biochem 1993 30: 326–328
Clark RE, Lee ES . Severe hypophosphataemia during stem cell harvesting in chronic myeloid leukaemia Br J Haematol 1995 90: 450–452
Raanani P, Berkowicz M, Harden I, Ben-Bassat I . Severe hypophosphataemia in autograft recipients during accelerated leucocyte recovery Br J Haematol 1995 91: 1031–1033
Crook M, Swaminathan R, Schey S . Hypophosphataemia in patients undergoing bone marrow transplantation Leuk Lymphoma 1996 22: 335–337
Barri YM, Knochel JP . Hypercalcemia and electrolyte disturbances in malignancy Hematol Oncol Clin North Am 1996 10: 775–790
Barak V, Schwartz A, Kalickman I et al. Prevalence of hypophosphatemia in sepsis and infection: the role of cytokines Am J Med 1998 104: 40–47
Bugg NC, Jones JA . Hypophosphatemia. Pathophysiology, effects and management on the intensive care unit Anaesthesia 1998 53: 895–902
Crook M, Schey S . Bone marrow transplantation and severe hypophosphataemia Br J Haematol 1996 93: 250
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Steiner, M., Steiner, B., Wilhelm, S. et al. Severe hypophosphatemia during hematopoietic reconstitution after allogeneic peripheral blood stem cell transplantation. Bone Marrow Transplant 25, 1015–1016 (2000). https://doi.org/10.1038/sj.bmt.1702407
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1702407
Keywords
This article is cited by
-
Tumour genesis syndrome: severe hypophosphatemia and hypokalemia may be ominous presenting findings in childhood acute myeloid leukaemia
European Journal of Pediatrics (2017)
-
Effect of ferric carboxymaltose on serum phosphate and C-terminal FGF23 levels in non-dialysis chronic kidney disease patients: post-hoc analysis of a prospective study
BMC Nephrology (2013)
-
Hyperphosphatemia during spontaneous tumor lysis syndrome culminate in severe hypophosphatemia at the time of blast crisis of Phneg CML to acute myelomoncytic leukemia
Experimental Hematology & Oncology (2012)
-
Hypophosphatemia: an evidence-based approach to its clinical consequences and management
Nature Clinical Practice Nephrology (2006)
-
Severe metabolic abnormalities after allogeneic hematopoietic cell transplantation
Bone Marrow Transplantation (2005)