Clinical Study

Assessment of Ondansetron-Associated Hypokalemia in Pediatric Oncology Patients

Table 1

Patient characteristics, diagnosis, and medication history.

PtAge (years)GenderHeight
(cm)
Weight (kg)DiagnosisChemotherapy protocol and additional medicationsMedications received 24 hr prior to observationMedications received during preondansetron observation periodMedications received during postondansetron observation period

111.5F14634.5Before B-cell ALLAALL 0232
Cyclophosphamide 1000 mg/m2  × 1
Cytarabine 75 mg/m2/d × 13
6-Mercaptopurine 60 mg/m2/d × 13
Vincristine 1.5 mg/m2  × 1
PEG Asparaginase 6000 IU/m2  × 1
IT Methotrexate 15 mg/m2  × 6
IT Cytarabine 70 mg/m2  
Prednisone 60 mg/m2/d × 28 days
Daunorubicin 25 mg/m2/d × 4
Other:
Trimethoprim/sulfamethoxazole 160 mg (TMP) po BID × 3 days
Colace 100 mg po BID
Senokot 1 tablet po QHS
NoneNoneNone

2 16.5 M 181 68.6 Osteogenic sarcoma COG AOST 0331 Cycle 2, week 9
Methotrexate 12 g/m2  
Other:
Trimethoprim/sulfamethoxazole 160 mg (TMP) q AM and 80 mg (TMP) po qPM × 3 days
Colace 100 mg po BID
None None Decadron 10 mg po × 1, 5 mg po × 1, Methotrexate 20 g IV × 1

316.8M16752.2Extragonadal pure seminoma, stage 3CCG-8891/COG 9048
Cisplatin 20 mg/m2  × 5 days
Etoposide 100 mg/m2  × 5 d
Bleomycin 15 U/m2  × 1
Other:
Trimethoprim/sulfamethoxazole 160 mg (TMP) q AM and 80 mg (TMP) po qPM × 3 days
Colace 100 mg po BID
Senna2 tablets po BID
Lactulose 30 mL BID PRN
Codeine 16 mg q4h PRN
NoneNoneOndansetron 8 mg po × 4
Decadron 10 mg × 2, 5 mg × 3
Nabilone 1 mg × 3
Colace 100 mg po × 1
Bleomycin 24 mg IV × 1
Etoposide 160 IV × 2, Cisplatin 32 mg × 2

4 16.5 F 164 53.2 Nodular sclerosing Hodgkin’s
lymphoma, stage 1A
COG AOHD 0431 Cycle 2
Doxorubicin 25 mg/m2/day 1, 2
Vincristine 1.4 mg/m2 day 1, 8
Prednisone 40 mg/m2 day 1–7
Cyclophosphamide 600 mg/m2 day 1–7
G-CSF 5 mcg/kg d
Other:
Trimethoprim/sulfamethoxazole 160 mg (TMP) po BID × 3 days
Cascara 5 mL po × 1
Magnesium hydroxide 25 mL po × 1
None Ondansetron 8 mg × 3
Ranitidine 150 mg po × 1
Prednisone 30 mg × 1 Dimenhydrinate 50 mg
po × 1

5 16.6 F 177 55.6 Nodular sclerosing Hodgkin’s
lymphoma, stage 3
AHOD-0031 Cycle 2 with DECA
Doxorubicin 25 mg/m2/d × 2
Bleomycin 5 U/m2/d day 1, 10 U/m2/d day 8
Vincristine 1.4 mg/m2/d day 1, 8
Etoposide 100 mg/m2/d
Prednisone 40 mg/m2/d
Cyclophosphamide 800 mg/m2  × 1
Dexamethasone 10 mg/m2 day 1, 2
Cytarabine 3000 mg/m2 day 1, 2
Cisplatin 90 mg/m2 IV day 1
GCSF 5 mcg/kg/d
Other:
Trimethoprim/Sulfamethoxazole 160 mg (TMP) po BID × 3 days
Prednisone 35 mg po × 1 None Ondansetron 8 mg × 1
Dimenhydrinate 50 mg
IV × 2
Doxorubicin 42.5 mg
Bleomycin 8.5 U at Vincristine 2.4 mg at Etoposide 213 mg
Cyclophosphamide 1360 mg

67.5M11823.0MedulloblastomaCOG CNS 0331 Regimen B
Vincristine 1.5 mg/m2 day 1, 8
Cyclophosphamide 1000 mg/m2 day 1, 2
MESNA 360 mg/m2  × 3 doses with each Cyclophosphamide
Other:
Trimethoprim/sulfamethoxazole 80 mg (TMP) po BID × 3 days
NoneNoneDecadron 4 mg IV × 1, Ondansetron 4 mg IV × 1
Vincristine 1.4 mg IV
Mesna 325 mg IV, Cyclophosphamide 900 mg IV

7 12.5 M 156 61.7 Before B-cell ALL AALL 0232
Cyclophosphamide 1000 mg/m2  × 1
Cytarabine 75 mg/m2/d × 13
6-Mercaptopurine 60 mg/m2/d × 13
Vincristine 1.5 mg/m2  × 1
PEG Asparaginase 6000 IU/m2  × 1
IT Methotrexate 15 mg/m2  × 6
IT Cytarabine 70 mg/m2  
Prednisone 60 mg/m2/d × 28 days
Daunorubicin 25 mg/m2/d × 4
Other:
Trimethoprim/sulfamethoxazole 160 mg (TMP) po BID × 3 days
Domperidone 10 mg po QID
Citalopram 10 mg po daily
Omeprazole 20 mg po daily
Dimenhydrinate 50 mg
IV × 1
None Cyclophosphamide 800 mg IV × 1
Domperidone 10 mg × 1
6-Mercaptopurine
40 mg × 1

8 6.0 M 112 19.8 Biphenotypic leukemia Institutional Protocol
Ifosfamide 2.5 g/m2/d × 3
Etoposide 100 mg /m2/d × 3
Carboplatin 635 mg/m2 day 3
GCSF 5 mcg/kg/d
Other:
Trimethoprim/sulfamethoxazole 80 mg (TMP) po BID × 3 days
Dimenhydrinate 25 mg po q6h
PRN
Decadron 4 mg IV × 1
Voriconazole 100 mg po bid
None Ondansetron 4 mg × 1
Decadron 2 mg IV × 1

914.8M17188.2Before B-cell ALLCOG AALL 0232
Cyclophosphamide 1000 mg/m2  × 1
Cytarabine 75 mg/m2/d × 13
6-Mercaptopurine 60 mg/m2/d × 13
Vincristine 1.5 mg/m2  × 1
PEG Asparaginase 6000 IU/m2  × 1
IT Methotrexate 15 mg/m2 × 6
IT Cytarabine 70 mg/m2  
Prednisone 60 mg/m2/d × 28 days
Daunorubicin 25 mg/m2/d × 4
Other:
Trimethoprim/Sulfamethoxazole 160 mg (TMP) po BID × 3 days
NoneNoneCytarabine 150 mg IV
Cyclophosphamide 2 g IV
Ondansetron 8 mg IV × 1

10 13 F 139 33.5 Before B-cell ALL relapse Institutional Protocol Relapse 001 Maintenance
Cytarabine 2.9 mg/m2/d
Etoposide 290 mg/m2/d
Vincristine 0.7 mg/m2/d
Dexamethasone 6 mg/m2/d
Methotrexate po 200 mg/m2/d
6-Mercaptopurine 75 mg/m2/d
Cyclophosphamide 1100 mg/m2/d
× 1
Methotrexate IV 1000 mg/m2/d × 1
Leucovorin 10 mg/m2/d
IT Methotrexate 65 mg/m2/d
IT Cytarabine 25 mg/m2/d
Other:
Trimethoprim/Sulfamethoxazole 80 mg (TMP) po BID × 3 days
None None Methotrexate
1100 mg IV × 1

11 10.8 F 154 43.8 Osteogenic sarcoma AOST 0331, Cycle 2 week 9
Methotrexate 12 g/m2
Other:
Trimethoprim/Sulfamethoxazole 160 mg (TMP) po BID × 3 days
Colace 100 mg po daily PRN
Nabilone 0.3 mg po bid None Ondansetron 8 mg IV × 3, Decadron 8 mg IV/po prechemo,  
Decadron 4 mg IV/po
q6h × 3,  
Nabilone 0.5 mg po BID,
Diphenhydramine
50 mg IV

1216.8M17357.5Ewing’s sarcoma, stage 4AEWS0031 week 1
Vincristine 1.5 g/m2 day 1
Ifosfamide 3 g/m2 day 1, 2, 3
Doxorubicin 20 mg/m2 day 1, 2, 3
Etoposide 150 mg/m2 day 1, 2, 3
Other:
Trimethoprim/Sulfamethoxazole 160 mg (TMP) po BID × 3 days
Dimenhydrinate 25 mg
po × 1
NoneOndansetron 8 mg × 2 Lactulose 10 mL po × 2
Decadron 10 mg IV × 1
Decadron 5 mg IV × 3 Furosemide 10 mg IV × 2,  Nabilone 0.5–1 mg po × 2
Tylenol 975 mg po × 1
Dimenhydrinate 25 iv
q4h × 4