Hyperglycemia during Induction Therapy is Associated with Poorer Survival in Children with Acute Lymphocytic Leukemia - 07/08/11
, Siripoom V. McKay, MD a, M. Fatih Okcu, MD, MPH b, c, Jinrong Yan, MD b, c, Morey W. Haymond, MD a, Judith F. Margolin, MD b, c
Reprint requests: Rona Y. Sonabend, MD, Clinical Care Center, Suite 1020, 6621 Fannin St, CC 1020.05, Houston, TX 77030-2399.Abstract |
Objectives |
To investigate whether children with acute lymphocytic leukemia (ALL) who have development of hyperglycemia during induction may have worse relapse-free (RFS) and overall survival (OS) rates.
Study design |
A review of 167 children diagnosed with ALL between 1999 to 2002 at Texas Children’s Hospital was performed. Blood glucose concentrations during induction therapy were reviewed; patients were assigned to 3 groups: euglycemia (blood glucose < 140 mg/dL), mild hyperglycemia (blood glucose between 140-200 mg/dL), and overt hyperglycemia (blood glucose > 200 mg/dL). RFS and OS among groups were compared by use of Kaplan-Meier and Cox-proportional hazard analyses, adjusting for potential confounding variables.
Results |
The median follow-up in survivors was 6 years; there were 18 deaths and 36 relapses. Overt hyperglycemia was seen in 56 (34%) patients. Patients with overt hyperglycemia had poorer RFS (68% ± [SE] 6.7 vs 85% ± 3.6, P = .025) and OS (74% ± 6.1 vs 96% ± 1.9, P < .0001) at 5 years than their counterparts. Patients with overt hyperglycemia had 6.2 times (95% CI 1.6-24.7, P = .01) greater risk for death, independent of risk group and type of steroid.
Conclusions |
Overt hyperglycemia may be an independent predictor of survival in children with ALL.
Le texte complet de cet article est disponible en PDF.Mots-clés : ALL, BMI, BMI%, BMT, MH, OH, OS, RFS
Plan
| The Thrasher Research Fund sponsors this work. The authors declare no conflicts of interest. |
Vol 155 - N° 1
P. 73-78 - juillet 2009 Retour au numéro
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