Glucose Levels Before the Onset of Asparaginase Predicts Transient Hyperglycemia in Children With Acute Lymphoblastic Leukemia

Pediatr Blood Cancer. 2016 Jul;63(7):1181-4. doi: 10.1002/pbc.25956. Epub 2016 Apr 8.

Abstract

Background: Transient hyperglycemia (TH) represents an acknowledged adverse event that occurs during treatment in children with acute lymphoblastic leukemia (ALL) and has recently been associated with an increased risk for developing metabolic disturbances in future life. Our aim was to estimate the incidence of TH and to identify risk factors, thus serving as markers for identifying candidates for prevention interventions.

Procedure: All patients treated with induction treatment for ALL in our department from January 2004 to April 2015 had their data retrieved from medical files and retrospectively analyzed.

Results: One hundred and two children with ALL treated at our department were identified (49 females and 53 males) with a mean age of 6.03 ± 3.78 years at the time of diagnosis. Sixteen patients developed TH (15.68%). Age at diagnosis >10 years is associated with an 11-fold increase in the risk of developing TH. Additionally, fasting glucose on the eighth day of treatment is an important prognostic factor as fasting glucose >100 mg/dl at that time point is associated with a threefold increase in developing TH during residual treatment period.

Conclusions: Fasting glucose levels >110 mg/dl on the eighth day of treatment could serve as a trigger for intervention strategies that will prevent the development of TH in pediatric patients treated for ALL. Additional studies are needed to confirm and further extend this preliminary observation.

Keywords: ALL; asparaginase; glucocorticosteroids; hyperglycemia; pediatric.

MeSH terms

  • Adolescent
  • Asparaginase / administration & dosage
  • Asparaginase / adverse effects*
  • Blood Glucose / metabolism*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hyperglycemia* / blood
  • Hyperglycemia* / chemically induced
  • Infant
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / blood
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / drug therapy
  • Retrospective Studies
  • Risk Factors

Substances

  • Blood Glucose
  • Asparaginase