title: Transient hyperglycemia during childhood acute lymphocytic leukemia chemotherapy: an old event revisited.
abstract: Hyperglycemia has been described as a common event occurring during acute lymphocytic leukemia chemotherapy. It is associated with the synergistic effect of L-asparaginase and glucocorticoids, and related to poor outcome. Our goal was to compare clinical and laboratory findings between hyperglycemic episodes occurring during childhood acute lymphocytic leukemia induction chemotherapy. Here we describe 12 (3.8%) high-risk patients of 311 total patients, 9 (75%) of who are female. The 12 patients presented with 16 hyperglycemic episodes classified into adverse or satisfactory categories. There were no differences in clinical or laboratory variables among groups, although the majority of episodes occurred in pubescents, regardless of the type of glucocorticoid employed. Despite the fact that only 1 patient was overweight, pancreatitis was not diagnosed. Although we could not determine whether hyperglycemia predicts an adverse outcome, glucose evaluation played an important role during induction chemotherapy. To date, recognized risk factors for hyperglycemia no longer explain our findings, thus other mechanisms related to insulin secretion and action should be further studied.
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Federal University of Sao Paulo- UNIFESP/EPM, Brazil, Sao Paulo 04037-000, Brazil. aspinola.dped@epm.br
authors.forename: Angela Maria
authors.initials: AM
authors.lastname: Spinola-Castro
authors.forename: Adriana Aparecida
authors.initials: AA
authors.lastname: Siviero-Miachon
authors.forename: Solange
authors.initials: S
authors.lastname: Andreoni
authors.forename: Patricia Debora Cavalcanti
authors.initials: PD
authors.lastname: Tosta-Hernandez
authors.forename: Carla Renata Pacheco Donato
authors.initials: CR
authors.lastname: Macedo
authors.forename: Maria Lucia de Martino
authors.initials: ML
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000681:Amylases / Q000097:blood; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced*; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000188:drug therapy*; D012074:Remission Induction; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D001786:Blood Glucose; D005938:Glucocorticoids; D000681:Amylases