title: Incidence of Hyperglycemia during Induction of Remission Phase of Pediatric Acute Lymphoblastic Leukemia.
abstract: Hyperglycemia is frequently associated with acute lymphoblastic leukemia (ALL) therapy. It has long been recognized as a consequence of corticosteroids and asparaginase. These medications are usually administrated concurrently in high doses during the initial induction phase of chemotherapy. As a result, hyperglycemia frequently develops during this phase, with resolution after the steroids and asparaginase have been discontinued or reduced in dose. Various recent studies have evaluated the incidence of hyperglycemia in this particular group of patients and its relationship with chemotherapy. However the incidence of hyperglycemia during induction of remission therapy in children with ALL is not known, and is the subject of this study. To determine the incidence as well as identification of day of onset and duration of hyperglycemia and other complications during induction of remission therapy. This prospective cross-sectional study included 50 newly diagnosed patients aged 1-15 years and was done from December 2010 to May 2011 in the department of Pediatric Haemato Oncology, Bangabandhu Sheikh Mujib Medical University, Bangladesh. Hyperglycemia was defined as ≥2 random glucose determinations of ≥200mg/dl during the first 28 days of induction chemotherapy. Out of 50 patients, 4(8%) patients developed hyperglycemia during remission induction therapy. No significant difference was found between two groups regarding age distribution (p>0.05) and body weight (p>0.05). Among patients who developed hyperglycemia 3 patients (75%) and 1 patient (25%) experienced hyperglycemia during second week and third week of induction therapy respectively. Hyperglycemia persists <7 days in case of 3(75%) patients and >7 days in case of 1(25%) patients. The incidence of chemotherapy induced hyperglycemia in this present study is 8%. Most patients who develop therapy induced hyperglycemia recover when L-asparaginase and corticosteroids are discontinued and they suffer no long term adverse effects.
authors.affiliation: Dr Runa Laila, Child Specialist, Department of Pediatrics and Neonatology, United Hospital Limited, Dhaka, Bangladesh.
authors.forename: R
authors.initials: R
authors.lastname: Laila
authors.forename: A
authors.initials: A
authors.lastname: Islam
authors.forename: M M
authors.initials: MM
authors.lastname: Bhuiyan
mesh_terms: D000293:Adolescent; D001459:Bangladesh; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D006801:Humans; D006943:Hyperglycemia; D015994:Incidence; D007223:Infant; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma; D011446:Prospective Studies; D012074:Remission Induction