The effect of hyperglycemia during induction chemotherapy on the prognosis of pediatric acute lymphoblastic leukemia (ALL)

Background: Hyperglycemia is a common complication during treatment for acute lymphoblastic leukemia (ALL) and can be associated with multiple adverse outcomes. In this study, we investigated the effect of chemotherapy-induced hyperglycemia on response to treatment in pediatric ALL patients.Material and methods: ۱۹۲ ALL patients from ۲۰۰۹ to ۲۰۱۷ were divided into the case (glucose value ≥ ۲۰۰ mg/dl) and control (no hyperglycemia) groups. The two groups were compared in terms of length of hospital stay, nosocomial infection, delay in chemotherapy and remission, and survival rate. Results: Of the ۱۹۲ patients, ۴۴ (۲۲.۹۱%) met previously defined criteria of hyperglycemia. The mean (±SEM) length of hospital stay in the case and control groups was ۳۰.۲۳ (±۰.۷۱) and ۲۷.۴۹ (±۰.۴۲) days, respectively (P = ۰.۰۰۲). In the case group, ۲۳ patients (۵۲.۲۸%) and in the control group ۴۷ patients (۳۱.۷۵%) had delayed chemotherapy (P = ۰.۰۱). In the case group ۲۳ people (۵۲.۲۷%), and in the control group ۴۸ people (۳۲.۴۳%) developed nosocomial infections (P = ۰.۰۲). Everyone in the case group had a remission before a month, in the control also only ۲ (۱.۳%) didn’t experience remission in a month. The rate of one-year survival in the case and control group were ۸۸.۶۴% and ۸۴.۰۹%, and three-year survival was ۸۶.۴۸% and ۸۳.۱%, respectively.Conclusion: hyperglycemia in pediatrics with ALL is associated with increased length of hospital stay, delayed chemotherapy, and nosocomial infection, however, there was no significant difference between the two groups in terms of remission and survival.

Keywords:

Pediatric , Acute Lymphoblastic Leukemia , Hyperglycemia