Infectious complications and long-term outcomes in patients with diffuse large B-Cell lymphoma and diabetes mellitus

Pasvolsky, Oren; Berger, Tamar; Geiger, Karyn Revital; Akirov, Amit; Bshara, Elias; Raanani, Pia; Gafter‐Gvili, Anat; Shochat, Tzippy; Rozovski, Uri; Gurion, Ronit

doi:10.1080/10428194.2022.2118526

Cited by 1 publication

(2 citation statements)

References 23 publications

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“…Glucocorticoid-induced hyperglycemia in patients with existing DM increases the risk of febrile neutropenia (FN), insulin use, and cardiovascular disease [13,14]. Even in patients without DM, blood glucose levels exceeding 200 mg/dL during CHOP ± R therapy have been reported to extend FN hospitalization durations [4]. Moreover, glucocorticoid-induced hyperglycemia correlates signi cantly with chemotherapy modi cations, thereby shortening the prognosis in non-diabetic individuals and patients with type 2 diabetes treated with CHOP ± R for NHL [5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…This involves the administration of prednisolone, a glucocorticoid, at a dosage of 100 mg/day for 5 d in each cycle [1,2]. One of the signi cant adverse events associated with high-dose prednisolone is hyperglycemia, which increases the risk of febrile neutropenia (FN) development, thereby necessitating treatment modi cations [3,4]. Numerous reports indicate that hyperglycemia induced by rituximab (R)-CHOP can shorten survival, thus emphasizing the need for safe and effective glycemic control during prednisolone administration [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Effects and safety of dulaglutide treatment on glucocorticoid-induced hyperglycemia in patients treated with CHOP therapy

Suyama,

Shimizu,

Kumiko

et al. 2024

Preprint

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Purpose: Glucocorticoid-induced hyperglycemia is a serious adverse event of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) therapy and requires chemotherapy dose reduction and drug interruption for remediation. Previous reports have showed that the glucagon-like peptide 1 receptor agonist dulaglutide significantly improves glycemic control in glucocorticoid-induced hyperglycemia. Thus, we aimed to investigate the efficacy and safety of dulaglutide for glucocorticoid-induced hyperglycemia in patients with non-Hodgkin lymphoma treated with CHOP therapy. Methods: Ten newly diagnosed patients with non-Hodgkin lymphoma exhibiting glucocorticoid-induced hyperglycemia during initial cycle CHOP ± rituximab therapy were enrolled. Dulaglutide administration began during the second cycle. Glycemic control parameters (HbA1C, glycoalbumin, and fasting blood glucose) and adverse events were monitored alongside chemotherapy sessions. Results: Of the 10 patients, one patient discontinued CHOP treatment due to progression, one patient due to chemotherapy intolerance, and eight patients were finally evaluated. HbA1c and glycoalbumin reduced significantly post-dulaglutide initiation, thereby suggesting improved glycemic control without adverse events, such as hypoglycemia or pancreatitis. Challenges in glycemic assessment due to simultaneous declines in hemoglobin levels alongside HbA1C were noted. Conclusion: Dulaglutide exhibited promise in effectively managing glucocorticoid-induced hyperglycemia during CHOP therapy without serious adverse events.

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