title: Protracted Administration of L-Asparaginase in Maintenance Phase Is the Risk Factor for Hyperglycemia in Older Patients with Pediatric Acute Lymphoblastic Leukemia.
abstract: Although L-asparaginase related hyperglycemia is well known adverse event, it is not studied whether the profile of this adverse event is affected by intensification of L-asparaginase administration. Here, we analyzed the profile of L-asparaginase related hyperglycemia in a 1,176 patients with pediatric acute lymphoblastic leukemia treated according to the Japan Association of Childhood Leukemia Study ALL-02 protocol using protracted L-asparaginase administration in maintenance phase. We determined that a total of 75 L-asparaginase related hyperglycemia events occurred in 69 patients. Although 17 events (17/1176, 1.4%) developed in induction phase, which was lower incidence than those (10-15%) in previous reports, 45 events developed during the maintenance phase with protracted L-asparaginase administration. Multivariate analysis showed that older age at onset (≥ 10 years) was a sole independent risk factor for L-asparaginase-related hyperglycemia (P<0.01), especially in maintenance phase. Contrary to the previous reports, obesity was not associated with L-asparaginase-related hyperglycemia. These findings suggest that protracted administration of L-asparaginase is the risk factor for hyperglycemia when treating adolescent and young adult acute lymphoblastic leukemia patients.
authors: Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors: Hideki
authors: H
authors: Yoshida
authors: Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors: Toshihiko
authors: T
authors: Imamura
authors: Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors: Akiko M
authors: AM
authors: Saito
authors: Department of Pediatrics, Aomori Prefectural Central Hospital, Aomori, Japan.
authors: Yoshihiro
authors: Y
authors: Takahashi
authors: Division of General Pediatrics and Emergency Medicine, Department of Pediatrics, Oita University, Oita, Japan.
authors: So-ichi
authors: S
authors: Suenobu
authors: Department of Hematology/Oncology, Hyogo Prefectural Children's Hospital, Kobe, Japan.
authors: Daiichiro
authors: D
authors: Hasegawa
authors: Department of Pediatrics, Mie University, Tsu, Japan.
authors: Takao
authors: T
authors: Deguchi
authors: Department of Pediatrics, Osaka University, Suita, Japan.
authors: Yoshiko
authors: Y
authors: Hashii
authors: Department of Pediatrics, Kansai Medical University, Hirakata, Japan.
authors: Hirohide
authors: H
authors: Kawasaki
authors: Department of Pediatrics, Iwate Medical University, Morioka, Japan.
authors: Mikiya
authors: M
authors: Endo
authors: Department of Pediatrics, Mie University, Tsu, Japan.
authors: Hiroki
authors: H
authors: Hori
authors: Department of Pediatrics, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan.
authors: Nobuhiro
authors: N
authors: Suzuki
authors: Department of Hematology/Oncology, Hyogo Prefectural Children's Hospital, Kobe, Japan.
authors: Yoshiyuki
authors: Y
authors: Kosaka
authors: Department of Hematology Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors: Koji
authors: K
authors: Kato
authors: Yumura Clinic, Osaka, Japan.
authors: Keiko
authors: K
authors: Yumura-Yagi
authors: Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan.
authors: Junichi
authors: J
authors: Hara
authors: Department of Pediatrics, Okayama University, Okayama, Japan.
authors: Megumi
authors: M
authors: Oda
authors: Department of Pediatric Hematology/Oncology, Miyagi Children's Hospital, Sendai, Japan.
authors: Atsushi
authors: A
authors: Sato
authors: Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors: Keizo
authors: K
authors: Horibe
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001215:Asparaginase / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced* / Q000453:epidemiology*; D007223:Infant; D060046:Maintenance Chemotherapy / Q000009:adverse effects / Q000379:methods; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D001215:Asparaginase