Case Report
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Year 2024, Volume: 6 Issue: 4, 167 - 170, 29.10.2024
https://doi.org/10.46310/tjim.1494510

Abstract

References

  • Hanada M, Delia D, Aiello A, Stadtmauer E, Reed JC. bcl-2 gene hypomethylation and high-level expression in B-cell chronic lymphocytic leukemia. Blood. 1993 Sep 15;82(6):1820-8.
  • van der Lubbe N, Lugtenburg PJ, Hoorn EJ. Electrolyte disorders secondary to venetoclax. Clin Kidney J. 2020 Jun 15;14(4):1272-4. doi: 10.1093/ckj/sfaa091.
  • Torres Cruz L, Pulipaka SP, Anthony N, Liu J, Barkhodarian M, Al Awwa A, Weissman S. A rare case of severe hypokalemia and hypomagnesemia due to venetoclax and polypharmacy leading to life-threatening cardiac arrhythmias. Case Rep Oncol. 2023 Nov 14;16(1):1390-4. doi: 10.1159/000534135.
  • Coutre S, Choi M, Furman RR, Eradat H, Heffner L, Jones JA, Chyla B, Zhou L, Agarwal S, Waskiewicz T, Verdugo M, Humerickhouse RA, Potluri J, Wierda WG, Davids MS. Venetoclax for patients with chronic lymphocytic leukemia who progressed during or after idelalisib therapy. Blood. 2018 Apr 12;131(15):1704-11. doi: 10.1182/blood-2017-06-788133.
  • Jones JA, Mato AR, Wierda WG, Davids MS, Choi M, Cheson BD, Furman RR, Lamanna N, Barr PM, Zhou L, Chyla B, Salem AH, Verdugo M, Humerickhouse RA, Potluri J, Coutre S, Woyach J, Byrd JC. Venetoclax for chronic lymphocytic leukaemia progressing after ibrutinib: an interim analysis of a multicentre, open-label, phase 2 trial. Lancet Oncol. 2018 Jan;19(1):65-75. doi: 10.1016/S1470-2045(17)30909-9.
  • Davids MS, Hallek M, Wierda W, Roberts AW, Stilgenbauer S, Jones JA, Gerecitano JF, Kim SY, Potluri J, Busman T, Best A, Verdugo ME, Cerri E, Desai M, Hillmen P, Seymour JF. Comprehensive safety analysis of venetoclax monotherapy for patients with relapsed/refractory chronic lymphocytic leukemia. Clin Cancer Res. 2018 Sep 15;24(18):4371-9. doi: 10.1158/1078-0432.CCR-17-3761.
  • Stilgenbauer S, Eichhorst B, Schetelig J, Hillmen P, Seymour JF, Coutre S, Jurczak W, Mulligan SP, Schuh A, Assouline S, Wendtner CM, Roberts AW, Davids MS, Bloehdorn J, Munir T, Böttcher S, Zhou L, Salem AH, Desai M, Chyla B, Arzt J, Kim SY, Verdugo M, Gordon G, Hallek M, Wierda WG. Venetoclax for patients with chronic lymphocytic leukemia with 17p deletion: Results from the full population of a phase II pivotal trial. J Clin Oncol. 2018 Jul 1;36(19):1973-80. doi: 10.1200/JCO.2017.76.6840. Erratum in: J Clin Oncol. 2019 Sep 1;37(25):2299. doi: 10.1200/JCO.19.00384.
  • Veis DJ, Sorenson CM, Shutter JR, Korsmeyer SJ. Bcl-2-deficient mice demonstrate fulminant lymphoid apoptosis, polycystic kidneys, and hypopigmented hair. Cell. 1993 Oct 22;75(2):229-40. doi: 10.1016/0092-8674(93)80065-m.

A case of hypocalcemia, hypophosphatemia and hypomagnesemia in association with Venetoclax

Year 2024, Volume: 6 Issue: 4, 167 - 170, 29.10.2024
https://doi.org/10.46310/tjim.1494510

Abstract

Venetoclax is a drug commonly associated with tumor lysis syndrome (TLS) and electrolyte imbalances. However, its effects on electrolyte metabolism are not limited to TLS. We present a patient with relapsed chronic lymphocytic leukemia who experienced electrolyte imbalances as grade 2 hypocalcemia, hypophosphatemia, and hypomagnesemia during the venetoclax escalation period, independent of TLS or renal or gastrointestinal loss. The patient was successfully managed with close electrolyte monitoring and appropriate electrolyte replacement without discontinuing venetoclax. There is limited data on electrolyte imbalances associated with venetoclax other than TLS. Studies show the incidence and severity of electrolyte imbalances, but managing these adverse events is not clear enough. Therefore, we would like to share our approach and experience with a patient who developed venetoclax-induced hypocalcemia, hypophosphatemia, and hypomagnesemia.

References

  • Hanada M, Delia D, Aiello A, Stadtmauer E, Reed JC. bcl-2 gene hypomethylation and high-level expression in B-cell chronic lymphocytic leukemia. Blood. 1993 Sep 15;82(6):1820-8.
  • van der Lubbe N, Lugtenburg PJ, Hoorn EJ. Electrolyte disorders secondary to venetoclax. Clin Kidney J. 2020 Jun 15;14(4):1272-4. doi: 10.1093/ckj/sfaa091.
  • Torres Cruz L, Pulipaka SP, Anthony N, Liu J, Barkhodarian M, Al Awwa A, Weissman S. A rare case of severe hypokalemia and hypomagnesemia due to venetoclax and polypharmacy leading to life-threatening cardiac arrhythmias. Case Rep Oncol. 2023 Nov 14;16(1):1390-4. doi: 10.1159/000534135.
  • Coutre S, Choi M, Furman RR, Eradat H, Heffner L, Jones JA, Chyla B, Zhou L, Agarwal S, Waskiewicz T, Verdugo M, Humerickhouse RA, Potluri J, Wierda WG, Davids MS. Venetoclax for patients with chronic lymphocytic leukemia who progressed during or after idelalisib therapy. Blood. 2018 Apr 12;131(15):1704-11. doi: 10.1182/blood-2017-06-788133.
  • Jones JA, Mato AR, Wierda WG, Davids MS, Choi M, Cheson BD, Furman RR, Lamanna N, Barr PM, Zhou L, Chyla B, Salem AH, Verdugo M, Humerickhouse RA, Potluri J, Coutre S, Woyach J, Byrd JC. Venetoclax for chronic lymphocytic leukaemia progressing after ibrutinib: an interim analysis of a multicentre, open-label, phase 2 trial. Lancet Oncol. 2018 Jan;19(1):65-75. doi: 10.1016/S1470-2045(17)30909-9.
  • Davids MS, Hallek M, Wierda W, Roberts AW, Stilgenbauer S, Jones JA, Gerecitano JF, Kim SY, Potluri J, Busman T, Best A, Verdugo ME, Cerri E, Desai M, Hillmen P, Seymour JF. Comprehensive safety analysis of venetoclax monotherapy for patients with relapsed/refractory chronic lymphocytic leukemia. Clin Cancer Res. 2018 Sep 15;24(18):4371-9. doi: 10.1158/1078-0432.CCR-17-3761.
  • Stilgenbauer S, Eichhorst B, Schetelig J, Hillmen P, Seymour JF, Coutre S, Jurczak W, Mulligan SP, Schuh A, Assouline S, Wendtner CM, Roberts AW, Davids MS, Bloehdorn J, Munir T, Böttcher S, Zhou L, Salem AH, Desai M, Chyla B, Arzt J, Kim SY, Verdugo M, Gordon G, Hallek M, Wierda WG. Venetoclax for patients with chronic lymphocytic leukemia with 17p deletion: Results from the full population of a phase II pivotal trial. J Clin Oncol. 2018 Jul 1;36(19):1973-80. doi: 10.1200/JCO.2017.76.6840. Erratum in: J Clin Oncol. 2019 Sep 1;37(25):2299. doi: 10.1200/JCO.19.00384.
  • Veis DJ, Sorenson CM, Shutter JR, Korsmeyer SJ. Bcl-2-deficient mice demonstrate fulminant lymphoid apoptosis, polycystic kidneys, and hypopigmented hair. Cell. 1993 Oct 22;75(2):229-40. doi: 10.1016/0092-8674(93)80065-m.
There are 8 citations in total.

Details

Primary Language English
Subjects Clinical Oncology
Journal Section Case Reports
Authors

Tuğcan Alp Kırkızlar 0000-0002-1361-6213

Publication Date October 29, 2024
Submission Date June 3, 2024
Acceptance Date August 15, 2024
Published in Issue Year 2024 Volume: 6 Issue: 4

Cite

EndNote Alp Kırkızlar T (October 1, 2024) A case of hypocalcemia, hypophosphatemia and hypomagnesemia in association with Venetoclax. Turkish Journal of Internal Medicine 6 4 167–170.

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