Table 2.
Drugs used in clinical hematology and associated underlying mechanisms for hyponatremia.
| Drug | Disease | Mechanism |
|---|---|---|
| Cyclophosphamide, ifosfamide [152,163,164,165] | Multiple myeloma, lymphomas | SIADH, hypotonic fluids to prevent hemorrhagic cystitis |
| Imatinib and other TKIs [160,161] | CML, ALL | SIADH |
| Entospletinib [166] | In development | SIADH |
| Vincristine [145,146,147] | Lymphomas, ALL | SIADH |
| Methotrexate [167] | Lymphomas, ALL | SIADH and CSWS |
| mTOR inhibitors (everolimus) [168] | In development | Aldosterone resistance |
| Tacrolimus [56] | Post AlloSCT | SIADH |
| Selinexor [153] | In development | Unknown |
| Cytarabine, Elacytarabine [169] | Lymphomatous meningitis, AML | Unknown |
| Hydroxyurea [170] | Myeloproliferative neoplasms, sickle cell disease | CSWS |
| Ibrutinib [154] | CLL, mantle cell lymphoma, Waldenstöm’s macroglobulinemia | Unknown |
| Nivolumab, Pembrolizumab [104,171,172] | Hodgkin lymphoma | Primary adrenal insufficiency, Diabetes mellitus |
| Rituximab plus lenalidomide [173] | Follicular lymphoma | Unknown |
| Pentostatin [174] | HCL | Unknown |
| Cyclosporine A [175] | Immunosuppression post AlloSCT | SIADH |
| Desmopressin [176,177] | Bleeding disorders | Unknown |
| Intravenous immunoglobulin (IVIG) [159] | ITP | Translocational effect of the osmotic load of sucrose and IVIG nephropathy |
| Bortezomib [178] | Multiple myeloma | SIADH |
| CD19+ chimeric antigen receptor (CAR) T-cells [150] | ALL, DLBCL, PMBCL | Elevated IL-6→ SIADH |
| Platinum compounds (cisplatin, carboplatin, oxaliplatin) [145,155,156] | Relapsed or refractory lymphomas | SIADH, CSWS, hypotonic fluids |
| Interferon [179] | HCL, CML, multiple myeloma, follicular lymphoma | SIADH |
| Melphalan [180] | Multiple myeloma | SIADH |
| Busulfan [109] | Prior to SCT | SIADH |
ALL: acute lymphocytic leukemia, AlloSCT: allogeneic stem cell transplantation, AML: acute myeloid leukemia, CML: chronic myeloid leukemia, CLL: chronic lymphocytic leukemia, CSWS: cerebral salt wasting syndrome, DLBCL: diffuse large B-cell lymphoma, HCL: hairy cell leukemia, ITP: immune thrombocytopenia mTOR: mammalian target of rapamycin, PMBCL: primary mediastinal B-cell lymphoma SIADH: syndrome of inappropriate secretion of antidiuretic hormone, TKIs: tyrosine kinase inhibitors.