Insulin-dependent diabetes: A chronic complication to acute pancreatitis in childhood acute lymphoblastic leukemia

Pediatr Blood Cancer. 2019 Jan;66(1):e27437. doi: 10.1002/pbc.27437. Epub 2018 Sep 14.

Abstract

Pancreatitis is a frequent toxicity to acute lymphoblastic leukemia (ALL) treatment, significantly associated with asparaginase use, and may be followed by severe complications such as acute hyperglycaemia, need for mechanical ventilation, pseudocysts, and death. Here, we provide novel data on seven patients diagnosed with diabetes after pancreatitis and still requiring insulin treatment after a median follow-up of 4.2 years (range: 1.7-9.2). We describe the clinical course of pancreatitis and illustrate the association between pancreatic pseudocysts, older age, and development of insulin-dependent diabetes. Together, this study documents the persisting burden of pancreatitis in childhood ALL and underlines the need for plasma glucose level monitoring.

Keywords: acute lymphoblastic leukemia; diabetes; pancreatitis; toxicity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Antineoplastic Agents / adverse effects*
  • Asparaginase / adverse effects*
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / etiology*
  • Diabetes Mellitus, Type 1 / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Pancreatitis / chemically induced
  • Pancreatitis / complications*
  • Pancreatitis / pathology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / physiopathology
  • Prognosis

Substances

  • Antineoplastic Agents
  • Asparaginase