Electrolyte changes in stem cell transplant recipients - A refutal of the 'Genesis' Syndrome

Electrolyte disorders are frequent in stem cell transplant recipients. However the reason,pattern and significance of the electrolyte disturbances in these patients needs to be clearly defined.We observed an increasing need for electrolyte supplementation during conditioning in stem cellrecipients with subsequent improvement with time prompting us to retrospectively analyse the serumelectrolyte values from admission till engraftment on 136 patients consecutively admitted to ourtransplant unit, over a one year period.We observed an electrolyte nadir predating donor cell infusionwith subsequent improvement .The shift in serum electrolytes were significant but in our observation,these predated the donor cell infusion.In conclusion we observed a patterned behaviour of serumelectrolytes with a nadir and subsequent rise antedating engraftment. This we postulate to besecondary to fluid shifts and altered oral intake occurring during conditioning in stem cell transplants.