Syndrome of inappropriate antidiuretic hormone secretion. A complication of high-dose intravenous melphalan

Authors:
  • BGBarbara Greenbaum-Lefkoe
    Barbara Greenbaum-Lefkoe
  • JRJeffrey G. Rosenstock
    Jeffrey G. Rosenstock
  • JBJean B. Belasco
    Jean B. Belasco
  • TRThomas M. Rohrbaugh
    Thomas M. Rohrbaugh
  • AMAnna T. Meadows
    Anna T. Meadows
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Abstract
Melphalan is now being investigated as an intravenous (IV) bolus chemotherapeutic agent in children with resistant tumors involving the bone marrow. Two patients received 2 mg/kg melphalan, IV bolus; 10 patients received 1 mg/kg. Seven of the ten patients receiving 1 mg/kg had noticeable downward trends in the serum sodium concentrations, whereas both patients receiving 2 mg/kg developed hyponatremia (serum sodium concentration [SNa], mEq/1 = 124‐125) and inappropriate urinary sodium losses. Syndrome of inappropriate antidiuretic hormone (SiADH) is a previously unreported complication of high dose bolus melphalan therapy.

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