Matthew Snyder1, Alexandra Shillingburg2,3, Michael Newton4, Mehdi Hamadani5, Abraham S Kanate6, Michael Craig6, Aaron Cumpston4,6. 1. Department of Pharmacy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA. 2. Department of Pharmacy, West Virginia University Medicine, Medical Center Drive, P.O. Box 8045, Morgantown, WV, 26506, USA. shillingburga@wvumedicine.org. 3. Osborn Hematopoietic Malignancy and Transplantation Program, Mary Babb Randolph Cancer Center, |West Virginia University, Morgantown, WV, USA. shillingburga@wvumedicine.org. 4. Department of Pharmacy, West Virginia University Medicine, Medical Center Drive, P.O. Box 8045, Morgantown, WV, 26506, USA. 5. Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI, USA. 6. Osborn Hematopoietic Malignancy and Transplantation Program, Mary Babb Randolph Cancer Center, |West Virginia University, Morgantown, WV, USA.
Abstract
PURPOSE: For an outpatient cancer center to operate efficiently, optimizing the use of chair time is essential. Allogeneic hematopoietic cell transplant (allo-HCT) recipients are seen frequently in this setting after hospital discharge and regularly for several months thereafter. Aggressive electrolyte replacement is commonly required in these patients, primarily due to renal wasting with calcineurin inhibitor use. Frequent intravenous (IV) magnesium repletion, requiring several hours of infusion time, is often needed in these patients to adequately manage their magnesium deficiencies. The purpose of this study is to explore the impact of extending the infusion rate of intravenous magnesium sulfate on the frequency and degree of IV magnesium replacements required in allo-HCT recipients. METHODS: We conducted a retrospective study to compare two cohorts of patients administered IV magnesium sulfate at a rate of 4 g/1 h versus 4 g/2 h. RESULTS: A total of 103 continuous patients were assessed in two groups as cohort 1 at the 4 g/1 h rate and cohort 2 at the 4 g/2 h rate. Cohort 1 required less IV magnesium per outpatient visit (median 2.2 vs. 2.9 g/visit, P = 0.0211) and less total IV magnesium replacement through day +100 (median 68 vs. 85 g, P = 0.0479) than cohort 2. CONCLUSION: These data suggest that there is no apparent benefit of prolonging magnesium infusion from 1 to 2 h in our outpatient allo-HCT population.
PURPOSE: For an outpatientcancer center to operate efficiently, optimizing the use of chair time is essential. Allogeneic hematopoietic cell transplant (allo-HCT) recipients are seen frequently in this setting after hospital discharge and regularly for several months thereafter. Aggressive electrolyte replacement is commonly required in these patients, primarily due to renal wasting with calcineurin inhibitor use. Frequent intravenous (IV) magnesium repletion, requiring several hours of infusion time, is often needed in these patients to adequately manage their magnesium deficiencies. The purpose of this study is to explore the impact of extending the infusion rate of intravenous magnesium sulfate on the frequency and degree of IV magnesium replacements required in allo-HCT recipients. METHODS: We conducted a retrospective study to compare two cohorts of patients administered IV magnesium sulfate at a rate of 4 g/1 h versus 4 g/2 h. RESULTS: A total of 103 continuous patients were assessed in two groups as cohort 1 at the 4 g/1 h rate and cohort 2 at the 4 g/2 h rate. Cohort 1 required less IV magnesium per outpatient visit (median 2.2 vs. 2.9 g/visit, P = 0.0211) and less total IV magnesium replacement through day +100 (median 68 vs. 85 g, P = 0.0479) than cohort 2. CONCLUSION: These data suggest that there is no apparent benefit of prolonging magnesium infusion from 1 to 2 h in our outpatient allo-HCT population.