title: L-asparaginase-induced abnormality in plasma glucose level in patients of acute lymphoblastic leukemia admitted to a tertiary care hospital of Odisha.
abstract: OBJECTIVE
  The objective of this study was to evaluate any abnormal change in plasma glucose levels in patients treated with L-asparaginase (L-Asp)-based chemotherapy regimen in patients of acute lymphoblastic leukemia (ALL).
  
  
  METHODS
  This retrospective, hospital-based study was conducted in patients of ALL, admitted to the Clinical Haematology Department of a tertiary care hospital of Odisha from August 2014 to July 2015. Indoor records of 146 patients on multi-centered protocol-841 were evaluated for any alteration in plasma glucose level, time of onset of hypo/hyperglycemia, and persistence of plasma glucose alteration.
  
  
  RESULTS
  Twenty-one percent of patients showed abnormal plasma glucose level. Most of these patients developed hypoglycemia and were of lower age group. Most of these patients developed hypoglycemia and were of lower age group, whereas a majority of higher age group patients developed hyperglycemia. In majority of the cases, abnormal glucose developed after three doses of L-Asp. Hypoglycemia subsided whereas hyperglycemia persisted till the end of our observation period.
  
  
  CONCLUSIONS
  L-Asp produces more incidences of hypoglycemia than hyperglycemia in a good number of ALL patients towards which clinicians should be more vigilant. However, hyperglycemia persists for a longer duration than hypoglycemia.
authors.affiliation: Department of Pharmacology, SCB Medical College, Cuttack, Odisha, India.
authors.forename: Mousumee
authors.initials: M
authors.lastname: Panigrahi
authors.affiliation: Department of Pharmacology, SCB Medical College, Cuttack, Odisha, India.
authors.forename: Trupti Rekha
authors.initials: TR
authors.lastname: Swain
authors.affiliation: Department of Clinical Haematology, SCB Medical College, Cuttack, Odisha, India.
authors.forename: Rabindra Kumar
authors.initials: RK
authors.lastname: Jena
authors.affiliation: Department of Clinical Haematology, SCB Medical College, Cuttack, Odisha, India.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Panigrahi
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001215:Asparaginase / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced; D007003:Hypoglycemia / Q000139:chemically induced; D007194:India; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000188:drug therapy; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001786:Blood Glucose; D001215:Asparaginase
keywords: Acute lymphoblastic leukemia; L-asparaginase; hyperglycemia; hypoglycemia