title: Glucocorticoid-induced diabetes mellitus in patients with lymphoma treated with CHOP chemotherapy.
abstract: OBJECTIVE
  Glucocorticoid-induced diabetes mellitus (GDM) is a major complication arising from corticosteroid administration, but there is lack of studies on GDM attributing to CHOP chemotherapy. We studied the incidence and risk factors for GDM development in patients with lymphoma during CHOP chemotherapy.
  
  
  METHODS
  We analyzed 80 patients with lymphoma treated with a CHOP regimen with or without rituximab between 2004 and 2012 at the University of Tsukuba hospital. Patients with a known history of DM were excluded. Diagnosis of DM was performed according to the American Diabetes Association's criteria.
  
  
  RESULTS
  Among the 80 patients, 26 (32.5 %) developed GDM. We found that age ≥ 60 years, glycated hemoglobin (HbA1c) levels >6.1 %, body mass index (BMI) >30 kg/m(2), prednisolone administration prior to chemotherapy, history of hypertension or hypertension at admission, and the presence of metabolic syndrome were significant (p ≤ 0.05) factors associated with GDM development by univariate analysis. Multivariate analysis revealed that age ≥ 60 years [p<0.05; hazard ratio (HR)=3.59; 95 % confidence interval (CI), 1.22-10.51], HbA1c levels >6.1 % (p<0.05; HR=9.35; 95%CI, 1.45-60.34), and BMI >30 kg/m(2) (p=0.052; HR=6.27; 95%CI, 0.98-40.00) were independently significant association factors.
  
  
  CONCLUSIONS
  The results suggest a guideline for plasma glucose monitoring during CHOP chemotherapy in patients with no history of DM.
authors.affiliation: Department of Hematology, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, 305-8575, Ibaraki, Japan.
authors.forename: Suk-Young
authors.initials: SY
authors.lastname: Lee
authors.forename: Naoki
authors.initials: N
authors.lastname: Kurita
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Masanori
authors.initials: M
authors.lastname: Seki
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okoshi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Chiba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003920:Diabetes Mellitus / Q000097:blood / Q000139:chemically induced*; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008223:Lymphoma / Q000097:blood* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D000069283:Rituximab; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D001786:Blood Glucose; D003520:Cyclophosphamide; D004317:Doxorubicin; D005938:Glucocorticoids; D006442:Glycated Hemoglobin; D011241:Prednisone; D000069283:Rituximab; D014750:Vincristine; C517652:hemoglobin A1c protein, human