The effect of hyperglycemia during induction chemotherapy on the prognosis of pediatric acute lymphoblastic leukemia (ALL)

Hyperglycemia is a common complication during treatment for acute lymphoblastic leukemia (ALL) and can be associated with multiple adverse outcomes. In this study, we investigated the effect of chemotherapy-induced hyperglycemia on response to treatment in pediatric ALL patients. 192 ALL patients from 2009 to 2017 were divided into the case (glucose value ≥ 200 mg/dl) and control (no hyperglycemia) groups. The two groups were compared in terms of length of hospital stay, nosocomial infection, delay in chemotherapy and remission, and survival rate. Of the 192 patients, 44 (22.91%) met previously defined criteria of hyperglycemia. The mean (±SEM) length of hospital stay in the case and control groups was 30.23 (±0.71) and 27.49 (±0.42) days, respectively (P = 0.002). In the case group, 23 patients (52.28%) and in the control group 47 patients (31.75%) had delayed chemotherapy (P = 0.01). In the case group 23 people (52.27%), and in the control group 48 people (32.43%) developed nosocomial infections (P = 0.02). Everyone in the case group had a remission before a month, in the control also only 2 (1.3%) didn’t experience remission in a month. The rate of one-year survival in the case and control group were 88.64% and 84.09%, and three-year survival was 86.48% and 83.1%, respectively. hyperglycemia in pediatrics with ALL is associated with increased length of hospital stay, delayed chemotherapy, and nosocomial infection, however, there was no significant difference between the two groups in terms of remission and survival.