Acid-base and electrolyte abnormalities in patients with acute leukemia

Disturbances of acid-base balance and electrolyte abnormalities are commonl y seen in patients with acute leukemia. Our study aimed at illuminating the probable pathogenetic mechanisms responsible for these disturbances in pat ients with acute leukemia admitted to our hospital. We studied 66 patients (24 men and 44 women) aged between 17 and 87 years old on their admission a nd prior to any therapeutic intervention. Patients with diabetes mellitus, acute or chronic renal failure, hepatic failure, patients receiving drugs t hat influence acid-base status and electrolyte parameters during the last m onth, such as corticosteroids, cisplatin, diuretics, antacids, aminoglycosi des, amphotericin, penicillin, and K+, PO43-, or Mg2+ supplements were excl uded. Forty-one patients had at least one acid-base or electrolyte disturba nce. There were no significant differences in the incidence of acid-base ba lance and electrolyte abnormalities between patients with acute myeloid leu kemia (AML) and patients with acute lymphoblastic leukemia (ALL), The most frequent electrolyte abnormality was hypokalemia, observed in 41 patients ( 63%), namely in 34 patients with AML, and 7 with ALL; the main underlying p athophysiologic mechanism was inappropriate kaliuresis, Furthermore, hypoka lemic patients more frequently experienced concurrent electrolyte disturban ces (i.e., hyponatremia, hypocalcemia, hypophosphatemia, and hypomagnesemia ), as well as various acid-base abnormalities compared to normokalemic pati ents. Hypokalemia in patients with acute leukemia may serve as an indicator of multiple concurrent, interrelated electrolyte disturbances, especially in patients with AML. (C) 1999 Wiley-Liss, Inc.