Hyperphosphatemia and hypocalcemia in Burkitt lymophoma. Complications of chemotherapy

In two patients, metabolic complications, previously unreported to our knowledge, of severe hyperphosphatemia and hypocalcemia in addition to hyperkalemia nad hyperuricemia were demonstrated after treatment with cyclophosphamide. In one patient, elevated blood and ascites lactate levels were measured. The levels decreased rapidly to normal following chemotherapy. The hyperphosphatemia and hyperkalemia may have been due to rapid tumor lysis and the hypocalcemia may have been caused by the hyperphosphatemia. The reduction in blood and aseties lactate levels may reflect the lysis of anaerobically metabolising tumor cells. Renal dialysis was required in the management of both cases. Because of the potential for cardiac arrythmias related to electrolyte imbalance, it is recommended that whenever possible reanl dialysis be available before treating cases of Burkitt lymphoma with large tumor burden.