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Hyperglycemia during induction therapy is associated with poorer survival in children with acute lymphocytic leukemia

Rona Y Sonabend1, Siripoom V McKay, M Fatih Okcu

  • 1Department of Pediatrics, Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX, USA. rys1@bcm.tmc.edu

The Journal of Pediatrics
|April 28, 2009
PubMed

Insights

Children with acute lymphocytic leukemia (ALL) experiencing overt hyperglycemia during induction therapy face significantly worse relapse-free survival and overall survival rates. This indicates hyperglycemia is a critical factor impacting treatment outcomes in pediatric ALL patients.

Area of Science:

  • Pediatric Oncology
  • Endocrinology

Background:

  • Acute lymphocytic leukemia (ALL) is a common childhood cancer.
  • Hyperglycemia, or high blood sugar, is a potential complication during cancer treatment.

Purpose of the Study:

  • To determine if hyperglycemia during induction therapy affects relapse-free survival (RFS) and overall survival (OS) in children with ALL.
  • To investigate hyperglycemia as an independent predictor of survival in pediatric ALL.

Main Methods:

  • Retrospective review of 167 children with ALL treated between 1999-2002.
  • Patients categorized into euglycemia (<140 mg/dL), mild hyperglycemia (140-200 mg/dL), and overt hyperglycemia (>200 mg/dL) groups based on blood glucose levels during induction.
  • Kaplan-Meier and Cox-proportional hazard analyses used to compare RFS and OS, adjusting for confounding variables.

Main Results:

  • Overt hyperglycemia observed in 34% of patients.
  • Patients with overt hyperglycemia showed significantly poorer RFS (68% vs 85%) and OS (74% vs 96%) at 5 years.
  • Overt hyperglycemia independently increased the risk of death by 6.2 times.

Conclusions:

  • Overt hyperglycemia during induction therapy is associated with worse survival outcomes in children with ALL.
  • Hyperglycemia may serve as an independent prognostic marker for survival in pediatric ALL patients.
Abstract

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