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Liposomal amphotericin B related late-onset hyperphosphatemia in a pediatric patient with acute myeloid leukemia

Sude Ayça Çifci1, Nadir Yalçın1, Tekin Aksu2

  • 1Department of Clinical Pharmacy, Faculty of Pharmacy, 37515Hacettepe University, Ankara, Turkey.

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners
|February 1, 2022
PubMed

Insights

Acute myeloid leukemia (AML) patients on long-term liposomal amphotericin B (AMBL) may develop late-onset hyperphosphatemia. This case highlights the need for increased provider awareness of this potential AMBL side effect.

Area of Science:

  • Pediatric Hematology Oncology
  • Infectious Diseases
  • Clinical Pharmacy

Background:

  • Children with acute myeloid leukemia (AML) face risks of significant electrolyte disturbances.
  • Invasive fungal infections are a common complication in pediatric AML patients.

Observation:

  • A case of late-onset hyperphosphatemia is presented in a pediatric AML patient receiving liposomal amphotericin B (AMBL).
  • The patient developed hyperphosphatemia on day 56 of treatment, despite receiving a low dose of AMBL (3-5 mg/kg/day) and maintaining normal renal function.

Findings:

  • This case suggests that cumulative dose exposure from prolonged AMBL therapy can lead to delayed-onset hyperphosphatemia.
  • This represents the first reported instance of late-onset hyperphosphatemia associated with low-dose AMBL in a patient with preserved renal function.

Implications:

  • Healthcare providers should be vigilant for hyperphosphatemia in pediatric AML patients undergoing long-term AMBL treatment, even with normal renal function.
  • Monitoring electrolyte levels is crucial for early detection and management of AMBL-associated hyperphosphatemia to prevent serious complications.
Abstract

Keywords:
Amphotericin Belectrolyte abnormalitieshyperphosphatemialiposomal amphotericin Bpediatric hematology

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