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

Abstract

Purpose: To investigate the impact of hyperglycemia during inductive treatment on the prognosis of acutelymphocytic leukemia (ALL) in children. Materials and <br/><b>Methods</b>: Clinical data of 159 ALL childhood cases werereviewed. The patients were divided into the hyperglycemia group (fasting glucose≥126mg/dl and/or randomblood glucose≥200mg/dl) and the euglycemia group according to the blood glucose values. The Χ2 test wasperformed to compare the complete remission rates of the two groups, and Kaplan-Meier and log-rank testswere performed to compare the 5-year overall and relapse-free survival. <br/><b>Results</b>: The incidence of hyperglycemiain the age≥10-year-old group was higher than the younger-age group (P=0.009). Values in the interim- andhigh-risk groups were higher than the standard-risk group (P=0.028), while there was no significant differencebetween 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%) vs80.2±9.1%, P<0.001). <br/><b>Conclusions</b>: Children with age≥10 years old, and in the middle- and high-risk groupsappear prone to complicating hyperglycemia during inductive chemotherapy, associated with lower 5-year OSand RFS.