Severe hypomagnesaemia with tetany following ESHAP protocol

BACKGROUND: One patient with B-cell Non-Hodgkin's Lymphoma developed severe hypomagnesaemia and tetany 15 days after the first course of treatment with ESHAP protocol. This prompted a careful look at the incidence and severity of hypomagnesaemia during treatment with this combination chemotherapy. METHOD: This patient and two further patients having the same treatment were monitored for hypomagnesaemia throughout their treatment period. RESULT: All three patients developed significant hypomagnesaemia requiring intravenous magnesium infusion in the second and third weeks after treatment though not after every course of chemotherapy. CONCLUSIONS: ESHAP protocol is often associated with significant hypomagnesaemia two to three weeks after treatment. Therefore, serum magnesium level should be monitored throughout the treatment period.