Impact of chemotherapy-related hyperglycemia on prognosis of child acute lymphocytic leukemia

Asian Pac J Cancer Prev. 2014;15(20):8855-9. doi: 10.7314/apjcp.2014.15.20.8855.

Abstract

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≥126 mg/dl and/or random blood glucose≥200 mg/dl) and the euglycemia group according to the blood glucose values. The ?2 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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Blood Glucose / analysis
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperglycemia / chemically induced
  • Hyperglycemia / mortality*
  • Infant
  • Male
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology
  • Prognosis
  • Remission Induction
  • Retrospective Studies
  • Survival Rate

Substances

  • Blood Glucose