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Acute Leukemias

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

Leukemia volume 23, pages 245–250 (2009)Cite this article

Abstract

Hyperglycemia adversely affects outcome in adult patients with acute lymphoblastic leukemia (ALL), but its impact on children with this disease is unknown. We evaluated the relationship between hyperglycemia during remission induction therapy and clinical outcomes among pediatric patients with ALL. We reviewed the records of patients enrolled on four consecutive ALL protocols (Total Therapy protocols XIIIA, XIIIB, XIV and XV) at St Jude Children's Research Hospital from 1991 to 2007 and identified those who experienced hyperglycemia (glucose ⩾200 mg per 100 ml) during remission induction. Complete remission (CR) rates at the end of induction, event-free survival (EFS), overall survival (OS), cumulative incidence of relapse and occurrence of infections were compared between those who did and did not experience hyperglycemia. Of 871 patients analyzed, 141 (16%) experienced hyperglycemia during remission induction. Patients with hyperglycemia were significantly older than the other patients (P<0.0001). There was no significant difference in CR rate (P=0.92), EFS (P=0.80), OS (P=0.28), cumulative incidence of relapse (P=0.59) or in the probability or types of infection between patients who did and did not experience hyperglycemia. Pediatric patients with or without hyperglycemia during remission induction for ALL have similar clinical outcome. Occurrence of hyperglycemia does not warrant alteration of the antileukemic regimen.

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Acknowledgements

This study was supported by grants (CA-21765, CA-51001, CA-36401, CA-78224, CA-60419, GM-61393) from the National Institutes of Health, and by the American Lebanese Syrian Associated Charities. Dr Pui is an American Cancer Society Professor.

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Authors and Affiliations

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

    J R Roberson, H L Spraker, H Inaba, M L Metzger, J E Rubnitz, R C Ribeiro, J T Sandlund, S Jeha, C-H Pui & S C Howard

  2. Division of Endocrinology, St Jude Children's Research Hospital, Memphis, TN, USA

    J Shelso

  3. Department of Pediatrics, the University of Tennessee Health Science Center, Memphis, TN, USA

    J Shelso, M L Metzger, J E Rubnitz, C-H Pui & S C Howard

  4. Deparment of Biostatistics, St Jude Children's Research Hospital, Memphis, TN, USA

    Y Zhou

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Correspondence to S C Howard.

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Roberson, J., Spraker, H., Shelso, J. et al. Clinical consequences of hyperglycemia during remission induction therapy for pediatric acute lymphoblastic leukemia. Leukemia 23, 245–250 (2009). https://doi.org/10.1038/leu.2008.289

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