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

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.

Keywords

• hypocalcaemia
• hypophasphataemia
• hypomagnesaemia
• venetoclax

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