Impact of chemotherapy-related hyperglycemia on prognosis of child acute lymphocytic leukemia.

Purpose: To investigate the impact of hyperglycemia during inductive treatment on the prognosis of acute lymphocytic leukemia (ALL) in children. Materials and Methods: Clinical data of 159 ALL childhood cases were reviewed. The patients were divided into the hyperglycemia group (fasting glucose >= 126mg/dl and/or random blood glucose >= 200mg/dl) and the euglycemia group according to the blood glucose values. The X2 test was performed to compare the complete remission rates of the two groups, and Kaplan-Meier and log-rank tests were performed to compare the 5-year overall and relapse-free survival. Results: The incidence of hyperglycemia in the age >= 10-year-old group was higher than the younger-age group (P=0.009). Values in the interim- and high-risk groups were higher than the standard-risk group (P=0.028), while there was no significant difference between genders (P=0.056). The complete remission rates of the 2 groups demonstrated no significant difference (P=0.134), while the 5-year OS of the hyperglycemia group was lower than in the euglycemia group (83.8 +/- 6.0% vs 94.9 +/- 2.4%, P=0.014). The 5 -year RFS was significantly lower than the euglycemia group (62.9 +/- 8.7%) vs 80.2 +/- 9.1%, P<0.001). Conclusions: Children with age >= 10 years old, and in the middle- and high-risk groups appear prone to complicating hyperglycemia during inductive chemotherapy, associated with lower 5-year OS and RFS.