内容紹介
Summary
A man in his 50s with small cell lung cancer received amrubicin as the fourth-line therapy from August 201X-1. Serum phosphorus levels before treatment were normal at 2.9 mg/dL, but grade 2 hypophosphatemia(2.1 mg/dL)was observed at the beginning of the 2nd course. He underwent laryngoplasty after the 4th course. Retreatment was initiated in June 201X due to disease progression. After reinitiating treatment, the disease developed to grade 3 hypophosphatemia. As we identified lower levels(1.1 mg/dL)at the start of the 10th course, a pharmacist proposed oral phosphate therapy to the attending physician, which we administered. After then, the levels improved to 2.2 mg/dL; thus, oral phosphate therapy was interrupted. However, because of a decline in serum phosphorus levels to grade 3, we administered the therapy again, and observed favorable improvement. For hypophosphatemia in this case, general reasons in clinical practice were not applicable; thus, amrubicin is considered to be a most possible cause.
要旨
症例は50歳台,男性。小細胞肺癌に対するfourth-lineの治療として201X-1年8月よりアムルビシンを実施した。治療前の血清リン値は2.9 mg/dLと正常であったが,2コース目開始時に2.1 mg/dLとgrade 2の低リン血症を認めた。4コース実施後に喉頭形成術を実施した。その後,疾患の進行により201X年6月に治療を再開した。治療再開後はgrade 3の低リン血症を来すようになり,10コース目開始時に1.1 mg/dLと低値を認めたため,薬剤師より医師にリン酸塩の内服治療を提案し実施したところ2.2 mg/dLへ改善した。リン酸塩を中止したが,血清リン値の再低下(grade 3)のため同薬を再開し改善した。本症例での低リン血症について臨床での一般的な原因は当てはまらず,アムルビシンによると考えられた。
目次
A man in his 50s with small cell lung cancer received amrubicin as the fourth-line therapy from August 201X-1. Serum phosphorus levels before treatment were normal at 2.9 mg/dL, but grade 2 hypophosphatemia(2.1 mg/dL)was observed at the beginning of the 2nd course. He underwent laryngoplasty after the 4th course. Retreatment was initiated in June 201X due to disease progression. After reinitiating treatment, the disease developed to grade 3 hypophosphatemia. As we identified lower levels(1.1 mg/dL)at the start of the 10th course, a pharmacist proposed oral phosphate therapy to the attending physician, which we administered. After then, the levels improved to 2.2 mg/dL; thus, oral phosphate therapy was interrupted. However, because of a decline in serum phosphorus levels to grade 3, we administered the therapy again, and observed favorable improvement. For hypophosphatemia in this case, general reasons in clinical practice were not applicable; thus, amrubicin is considered to be a most possible cause.
要旨
症例は50歳台,男性。小細胞肺癌に対するfourth-lineの治療として201X-1年8月よりアムルビシンを実施した。治療前の血清リン値は2.9 mg/dLと正常であったが,2コース目開始時に2.1 mg/dLとgrade 2の低リン血症を認めた。4コース実施後に喉頭形成術を実施した。その後,疾患の進行により201X年6月に治療を再開した。治療再開後はgrade 3の低リン血症を来すようになり,10コース目開始時に1.1 mg/dLと低値を認めたため,薬剤師より医師にリン酸塩の内服治療を提案し実施したところ2.2 mg/dLへ改善した。リン酸塩を中止したが,血清リン値の再低下(grade 3)のため同薬を再開し改善した。本症例での低リン血症について臨床での一般的な原因は当てはまらず,アムルビシンによると考えられた。