Related Experiment Video

Updated: Jul 4, 2026

Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
08:31

Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia

Published on: October 17, 2025

Hyperglycemia during induction therapy is associated with increased infectious complications in childhood acute

Rona Y Sonabend1, Siripoom V McKay, M Fatih Okcu

  • 1Department of Pediatrics, Endocrinology and Metabolism, Baylor College of Medicine, Houston, Texas, USA.

Pediatric Blood & Cancer
|June 5, 2008
PubMed

Insights

Children with acute lymphocytic leukemia (ALL) who develop hyperglycemia during chemotherapy face a higher risk of infection. This study found that overt hyperglycemia significantly increased the likelihood of serious infections in pediatric ALL patients.

Area of Science:

  • Pediatric Oncology
  • Infectious Diseases
  • Endocrinology

Background:

  • Children with acute lymphocytic leukemia (ALL) are susceptible to hyperglycemia.
  • Adult ALL patients with hyperglycemia experience worse outcomes.
  • Data on pediatric ALL and hyperglycemia-related infections are lacking.

Purpose of the Study:

  • To investigate the association between hyperglycemia and infection risk in pediatric ALL patients during induction chemotherapy.
  • To determine if hyperglycemia is a risk factor for infectious complications in children with ALL.

Main Methods:

  • Retrospective chart review of 135 pediatric ALL patients (1999-2001).
  • Categorization into euglycemic, mild hyperglycemic (MH), and overt hyperglycemic (OH) groups based on blood glucose levels.
  • Comparison of infectious outcomes within the first year of therapy.

Main Results:

  • 56% of patients exhibited hyperglycemia (21% MH, 35% OH).
  • Hyperglycemia was more common in older children and those overweight at diagnosis.
  • MH and OH groups had 2.1-2.5 times higher rates of documented infections.
  • OH group showed significantly increased risk for bacteremia/fungemia, cellulitis, and neutropenic fever.

Conclusions:

  • Hyperglycemia, particularly overt hyperglycemia, is a potential risk factor for infections in pediatric ALL.
  • Early identification and management of hyperglycemia may reduce infectious complications in these children.
Abstract

Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Complications of Diabetes Mellitus01:22

Complications of Diabetes Mellitus

Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency, resistance, or both. Prolonged hyperglycemia disrupts metabolic homeostasis and leads to acute and chronic complications.Acute ComplicationsAcute complications result from sudden metabolic imbalance.Diabetic ketoacidosis (DKA) mainly appears in type 1 diabetes but may also develop in type 2 diabetes, particularly under extreme stress. It arises from severe insulin deficiency,...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Immunodeficiency Diseases01:25

Immunodeficiency Diseases

Immunodeficiency disorders are conditions in which the immune system's ability to fight infectious disease and cancer is compromised or entirely absent. The immune system comprises a complex network of cells, tissues, and organs that work together to protect the body from potentially harmful invaders. When this system is deficient or not functioning properly, it leaves the body susceptible to infections, diseases, or other complications.
There are three main causes of immunodeficiency disorders...
Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...