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Published on: October 17, 2025

Clinical consequences of hyperglycemia during remission induction therapy for pediatric acute lymphoblastic leukemia

J R Roberson1, H L Spraker, J Shelso

  • 1Department of Oncology, St Jude Children's Research Hospital, Memphis, TN 38105, USA.

Leukemia
|October 17, 2008
PubMed

Insights

Hyperglycemia, or high blood sugar, does not impact treatment outcomes for pediatric patients with acute lymphoblastic leukemia (ALL). This finding suggests that current leukemia treatment regimens do not need adjustment for children experiencing hyperglycemia during induction therapy.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Endocrinology

Background:

  • Hyperglycemia is known to negatively affect outcomes in adult acute lymphoblastic leukemia (ALL) patients.
  • The impact of hyperglycemia on pediatric ALL patients remains largely unknown.
  • Understanding this relationship is crucial for optimizing treatment strategies in children.

Purpose of the Study:

  • To investigate the association between hyperglycemia during remission induction therapy and clinical outcomes in pediatric ALL patients.
  • To determine if hyperglycemia influences complete remission rates, survival, relapse incidence, or infection rates.
  • To inform clinical decisions regarding treatment modifications for pediatric ALL patients with hyperglycemia.

Main Methods:

  • Retrospective review of pediatric ALL patients treated on St Jude Total Therapy protocols (1991-2007).
  • Identification of patients experiencing hyperglycemia (glucose ≥200 mg/dL) during remission induction.
  • Comparison of clinical outcomes (CR, EFS, OS, relapse, infection) between hyperglycemic and non-hyperglycemic groups.

Main Results:

  • Of 871 pediatric ALL patients, 141 (16%) experienced hyperglycemia during induction; these patients were significantly older.
  • No significant differences were observed in complete remission rates, event-free survival, overall survival, or cumulative incidence of relapse between the groups.
  • The probability and types of infections were also similar between patients with and without hyperglycemia.

Conclusions:

  • Hyperglycemia during remission induction therapy does not appear to adversely affect clinical outcomes in pediatric patients with ALL.
  • The occurrence of hyperglycemia in pediatric ALL patients does not necessitate alterations to the established antileukemic treatment regimen.
  • These findings support the continued use of current therapeutic protocols for pediatric ALL, irrespective of transient hyperglycemia.

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