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.