Prevalence of transient hyperglycemia during induction chemotherapy for pediatric acute lymphoblastic leukemia

Lowas, Stefanie; Marks, Daniel L.; Malempati, Suman

doi:10.1002/pbc.21980

Cited by 84 publications

(127 citation statements)

References 22 publications

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“…A number of studies had confirmed that the age >10-year- old when initially diagnosed was the predilection age of hyperglycemia during the child ALL inductive remission period, and it was also a risk factor towards the ketoacidosis, the incidence of the hyperglycemia group was higher (Roberson et al, 2008;Lowas et al, 2009;Roberson et al, 2009;Sonabend et al, 2009;SpinolaCastro et al, 2009), and thus became the index of poor prognosis in a number of collaborative groups. In this study, the occurrence of hyperglycemia during the inductive chemotherapy did not significantly affect the CR rate of children (compared with the euglycemia group, 86.8% vs 95%, P=0.134), while the prognosis of the hyperglycemia group was poorer, the 5-year overall survival rate was significantly lower than the euglycemia group (83.1±6.3% vs 94.2±2.9%, P=0.014), the 5 -year relapse-free rate was also significantly lower than the euglycemia group (64.1±8.9% vs 88.6±3.8%, P<0.001).…”

Section: Discussionmentioning

confidence: 99%

Impact of Chemotherapy-Related Hyperglycemia on Prognosis of Child Acute Lymphocytic Leukemia

Zhang

Wang²,

Hou³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Purpose: To investigate the impact of hyperglycemia during inductive treatment on the prognosis of acute lymphocytic leukemia (ALL) in children. Materials and Methods: Clinical data of 159 ALL childhood cases were reviewed. The patients were divided into the hyperglycemia group (fasting glucose≥126mg/dl and/or random blood glucose≥200mg/dl) and the euglycemia group according to the blood glucose values. The Χ2 test was performed to compare the complete remission rates of the two groups, and Kaplan-Meier and log-rank tests were performed to compare the 5-year overall and relapse-free survival. Results: The incidence of hyperglycemia in the age≥10-year-old group was higher than the younger-age group (P=0.009). Values in the interim-and high-risk groups were higher than the standard-risk group (P=0.028), while there was no significant difference between genders (P=0.056). The complete remission rates of the 2 groups demonstrated no significant difference (P=0.134), while the 5-year OS of the hyperglycemia group was lower than in the euglycemia group (83.8±6.0% vs 94.9±2.4%, P=0.014). The 5 -year RFS was significantly lower than the euglycemia group (62.9±8.7%) vs 80.2±9.1%, P<0.001). Conclusions: Children with age≥10 years old, and in the middle-and high-risk groups appear prone to complicating hyperglycemia during inductive chemotherapy, associated with lower 5-year OS and RFS.Keywords: Childhood ALL -chemotherapy-related hyperglycemia -relapse-free rate -overall survival RESEARCH ARTICLE Impact of Chemotherapy-Related Hyperglycemia on Prognosis of Child Acute Lymphocytic LeukemiaBi-Hong Zhang 1 , Jian Wang 1 , Hong-Man Xue, Chun Chen* the L-asparaginase (L-asp) and glucocorticoids are the commonly used drugs during the child ALL inductive chemotherapy, which would affect the production, release and functions of insulin, the chemotherapy-related hyperglycemia is also a common complication of child ALL, with the occurring rate as 4% to 20%, or even as high as 56% (Belgaumi et al., 2003;Sonabend et al., 2008). Currently, the report about the impacts of hyperglycemia during the inductive chemotherapy towards the prognosis of child ALL is few, and the conclusions are inconsistent. This study compares the rates of complete remission, 5-year recurrence-free survival and 5-year overall survival between the hyperglycemic ALL children and the non-hyperglycemic ALL children during the inductive chemotherapy, aiming to analyze the relationship of hyperglycemia and prognosis of child ALL.

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Section: Discussionmentioning

confidence: 99%

Impact of Chemotherapy-Related Hyperglycemia on Prognosis of Child Acute Lymphocytic Leukemia

Zhang

Wang²,

Hou³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Hyperglycaemia and insulin resistance are common side effects in both diabetic and non-diabetic patients treated with GCs. Insulin resistance develops in around 30% of cancer patients using GCs, with higher percentages in patient groups receiving continuous high doses [41,42].…”

Section: Glucocorticoidsmentioning

confidence: 99%

Cancer-drug induced insulin resistance: Innocent bystander or unusual suspect

Ariaans

Jong

Gietema

et al. 2015

Cancer Treatment Reviews

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“…4,5 Hyperglycemia is a common occurrence in pediatric patients during induction chemotherapy of ALL. [6][7][8] The potential causes may include beta cell dysfunction caused by chemotherapeutic drugs such as L-asparaginase, increased insulin resistance and hepatic gluconeogenesis induced by corticosteroids, or synergistic effects of these medications, given that these pharmacological agents are usually combined during initial induction therapy. 4,5 The spectrum of hyperglycemia can range widely from transient isolated episodes to severe life-threatening complications such as diabetic ketoacidosis or non-ketotic hyperglycemic hyperosmolar syndrome.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Hyperglycemia During Chemotherapy for Acute Lymphoblastic Leukemia Among Taiwanese Children

Tsai

Huang

Chou

et al. 2015

Pediatrics & Neonatology

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Prevalence of transient hyperglycemia during induction chemotherapy for pediatric acute lymphoblastic leukemia

Abstract: The prevalence of TH in this study was higher than previously reported. Overweight, age >or=10 years, and use of native L-asparaginase were significant predictors of TH.

Cited by 84 publications

References 22 publications

Impact of Chemotherapy-Related Hyperglycemia on Prognosis of Child Acute Lymphocytic Leukemia

Impact of Chemotherapy-Related Hyperglycemia on Prognosis of Child Acute Lymphocytic Leukemia

Cancer-drug induced insulin resistance: Innocent bystander or unusual suspect

Risk Factors for Hyperglycemia During Chemotherapy for Acute Lymphoblastic Leukemia Among Taiwanese Children

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