Effect of Chemotherapy Related Hyperglycemia on Bone Marrow Response to Induction Treatment in Children with Acute Lymphoblastic Leukemia

Abstract

background: acute lymphoblastic leukemia (ALL) is a group of hematological neoplasia that accounts for 25% of childhood cancers and up to 75% of childhood leukemia. Hyperglycemia is one of the common side effects of chemotherapy that affects survival rates in adults, aim of this study is to show the effect of chemotherapy-related hyperglycemia on the response to treatment as remission conditions in children with ALL. Patients and methods: prospective study carried out in the Clinical Pathology Department of Sohag Oncology Center and Sohag University Hospital, on total 109 patients in addition to 20 healthy children as control group the study depends on measuring random blood glucose level before, during and after induction chemotherapy and comparing the response of bone marrow at the end of induction between hyperglycemic patients (random blood glucose ≥200 mg /dl) and euglycemic patients (random blood glucose within normal values). Results: patients developed hyperglycemia was 33 (30.3%) while patients with euglycemia were 76 (69.7%) and according to the remission state after induction chemotherapy, 99 patients (90.8%) had achieved complete remission state while 10 patients (9.2%) had no remission, 60% of patients with no remission were hyperglycemic during the induction period, and 26 (78,8%) of the 33 hyperglycemic patients aged ≥10years. Conclusion: hyperglycemia affects the rate of complete remission in ALL children during induction chemotherapy and its incidence is higher in the age group≥10 years old