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Homoharringtonine-induced hyperglycemia
R K Sylvester1, M Lobell, W Ogden
1Department of Pharmacy, United Hospital, St. Paul, MN 55102.
Summary
Homoharringtonine (HHT) can cause hyperglycemia by inducing insulin resistance. Patients receiving high-dose HHT infusions, those over 10 years old, or those with diabetes require regular blood glucose monitoring.
Area of Science:
- Oncology
- Endocrinology
- Pharmacology
Background:
- Homoharringtonine (HHT) is an alkaloid used in cancer treatment.
- Previous reports suggest HHT can induce hyperglycemia.
- The mechanism underlying HHT-induced hyperglycemia requires further characterization.
Purpose of the Study:
- To investigate the impact of Homoharringtonine (HHT) on insulin production and action.
- To elucidate the mechanism of HHT-induced hyperglycemia.
- To identify patient populations at increased risk for HHT-related hyperglycemia.
Main Methods:
- The study characterized the effects of HHT on insulin signaling pathways.
- Literature review was conducted to identify risk factors for HHT-induced hyperglycemia.
Main Results:
- HHT-induced hyperglycemia is primarily caused by the development of insulin resistance.
- Patients receiving continuous HHT infusions of 5 mg/m2/d or greater are at higher risk.
- Patients older than 10 years receiving HHT may also be at increased risk.
Conclusions:
- Homoharringtonine (HHT) treatment can lead to hyperglycemia due to insulin resistance.
- Routine blood glucose monitoring is recommended for at-risk patients.
- At-risk groups include those on high-dose HHT, patients over 10 years, diabetics, and those on concurrent asparaginase or prednisone therapy.