Magnesium depletion in patients receiving cisplatin-based chemotherapy

Area of Science:

• Oncology
• Nephrology
• Clinical Chemistry

Background:

• Cisplatin is a widely used chemotherapeutic agent.
• Hypomagnesaemia is a known side effect of cisplatin treatment.
• The impact of cisplatin dosage and supplementation protocols on magnesium levels requires further elucidation.

Purpose of the Study:

• To determine the incidence of hypomagnesaemia in patients receiving cisplatin-based chemotherapy.
• To investigate the relationship between cisplatin dosage, frequency, and cycle number with the degree of hypomagnesaemia.
• To evaluate the efficacy of routine magnesium supplementation in mitigating hypomagnesaemia.

Main Methods:

• A cohort of 214 patients undergoing cisplatin-based chemotherapy was studied.
• Serum magnesium levels were monitored throughout treatment across various chemotherapy regimens.
• Dose-response and supplementation effects were analyzed using multiple regression.

Main Results:

• A significant decrease in serum magnesium levels was observed during cisplatin chemotherapy (P < 0.0005).
• The incidence of hypomagnesaemia (serum magnesium < 0.7 mmol/l) was 43%.
• Cisplatin dose, frequency, and number of cycles were significantly associated with the degree of hypomagnesaemia (P = 0.001, P = 0.03, P < 0.0005).
• Adequate magnesium supplementation (60 mmol/cycle) effectively reduced hypomagnesaemia, while insufficient doses (20 mmol/cycle) did not.

Conclusions:

• Routine monitoring of magnesium levels is crucial for patients on cisplatin.
• Cisplatin-based chemotherapy regimens should include routine magnesium supplementation.
• Optimal magnesium supplementation doses range from 40-80 mmol per cycle, adjusted for the specific regimen.