Persistence of impaired pancreatic beta-cell function in children treated for acute lymphoblastic leukaemia.
Treatment for acute lymphoblastic leukaemia can induce alterations of glucose metabolism, but long-term follow-up data on this topic are still absent. We aimed to study glucose metabolism by intravenous and oral glucose tolerance testing in 32 children affected by acute lymphoblastic leukaemia and who were off-therapy for at least 1 year. 22 (69%) children presented with impaired first-phase insulin response, which in nine children was associated with impaired glucose tolerance and in one child with overt diabetes. Fasting insulin (4.65 mU/L, 95% CI 1.1-8.1; p=0.008), insulinogenic index (0.46; 0.02-0.98; p=0.03), and homoeostatic model assessment beta-cell function (80.1, 7.2-153; p=0.02) were reduced in the children with impaired insulin response. Chemotherapy for acute lymphoblastic leukaemia is associated with beta-cell function damage, which persists even after therapy has been stopped.
Mohn
Angelika
A
Department of Paediatrics, University of Chieti, Via Dei Vestini 15, 66100, Chieti, Italy. amohn@unich.it
Di Marzio
Alessandro
A
Capanna
Rita
R
Fioritoni
Giuseppe
G
Chiarelli
Francesco
F
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D007515:Islets of Langerhans / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*
D000970:Antineoplastic Agents; D001786:Blood Glucose; D007328:Insulin