Objectives:

To describe the incidence, severity and factors associated with the appearance of hypokalemia in patients with febrile neutropenia in treatment with liposomal amphotericin B.

Methods:

Retrospective unicenter study (January 2010-May 2020), which included those hematological patients with febrile neutropenia who were treated with liposomal amphotericin B for at least 72 h. The incidence of hypokalemia associated with the use of the drug, itsseverity, and the influence of potassiumsupplementation on the occurrence ofhypokalemia in this group of patientswere evaluated.

Results:

89 patients were included (50.6% women [n=45]; mean age 63.5 years [20-90]). 59.6% (n=53) of patients developed hypokalemia during treatment with liposomal amphotericin B: mild (52.8%, n=28), moderate (35.8%, n=19) and severe (11.3%, n=6). The use of early-onset potassium-based supplementation decreased the rate of occurrence of hypokalemia in these patients (p=0.001). The period between drug initiation and potassium intake was lower in patients who did not develop hypokalemia (p<0.001). Likewise, this group of patients benefited from longer periods of supplementation (p=0.002) and antifungal therapy (p=0.039).

Conclusions:

Hypokalemia is a very frequent adverse effect in patients with febrile neutropenia who are treated with liposomal amphotericin B. It is necessary to establish protocols for potassium supplementation to reduce the risk of this adverse reaction.

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