Clinical consequences of hyperglycemia during remission induction therapy for pediatric acute lymphoblastic leukemia

J. R. Roberson, H. L. Spraker, J. Shelso, Y. Zhou, H. Inaba, M. L. Metzger, J. E. Rubnitz, R. C. Ribeiro, J. T. Sandlund, S. Jeha, C. H. Pui, Scott Howard

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Hyperglycemia adversely affects outcome in adult patients with acute lymphoblastic leukemia (ALL), but its impact on children with this disease is unknown. We evaluated the relationship between hyperglycemia during remission induction therapy and clinical outcomes among pediatric patients with ALL. We reviewed the records of patients enrolled on four consecutive ALL protocols (Total Therapy protocols XIIIA, XIIIB, XIV and XV) at St Jude Children's Research Hospital from 1991 to 2007 and identified those who experienced hyperglycemia (glucose ≤200mg per 100ml) during remission induction. Complete remission (CR) rates at the end of induction, event-free survival (EFS), overall survival (OS), cumulative incidence of relapse and occurrence of infections were compared between those who did and did not experience hyperglycemia. Of 871 patients analyzed, 141 (16%) experienced hyperglycemia during remission induction. Patients with hyperglycemia were significantly older than the other patients (P<0.0001). There was no significant difference in CR rate (P=0.92), EFS (P=0.80), OS (P=0.28), cumulative incidence of relapse (P=0.59) or in the probability or types of infection between patients who did and did not experience hyperglycemia. Pediatric patients with or without hyperglycemia during remission induction for ALL have similar clinical outcome. Occurrence of hyperglycemia does not warrant alteration of the antileukemic regimen.

Original languageEnglish (US)
Pages (from-to)245-250
Number of pages6
JournalLeukemia
Volume23
Issue number2
DOIs
StatePublished - Jan 1 2009

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Remission Induction
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Hyperglycemia
Pediatrics
Therapeutics
Disease-Free Survival
Recurrence
Survival
Incidence
Infection
Glucose

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Clinical consequences of hyperglycemia during remission induction therapy for pediatric acute lymphoblastic leukemia. / Roberson, J. R.; Spraker, H. L.; Shelso, J.; Zhou, Y.; Inaba, H.; Metzger, M. L.; Rubnitz, J. E.; Ribeiro, R. C.; Sandlund, J. T.; Jeha, S.; Pui, C. H.; Howard, Scott.

In: Leukemia, Vol. 23, No. 2, 01.01.2009, p. 245-250.

Research output: Contribution to journalArticle

Roberson, JR, Spraker, HL, Shelso, J, Zhou, Y, Inaba, H, Metzger, ML, Rubnitz, JE, Ribeiro, RC, Sandlund, JT, Jeha, S, Pui, CH & Howard, S 2009, 'Clinical consequences of hyperglycemia during remission induction therapy for pediatric acute lymphoblastic leukemia', Leukemia, vol. 23, no. 2, pp. 245-250. https://doi.org/10.1038/leu.2008.289
Roberson, J. R. ; Spraker, H. L. ; Shelso, J. ; Zhou, Y. ; Inaba, H. ; Metzger, M. L. ; Rubnitz, J. E. ; Ribeiro, R. C. ; Sandlund, J. T. ; Jeha, S. ; Pui, C. H. ; Howard, Scott. / Clinical consequences of hyperglycemia during remission induction therapy for pediatric acute lymphoblastic leukemia. In: Leukemia. 2009 ; Vol. 23, No. 2. pp. 245-250.
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