TY - JOUR
T1 - The effect of combination of steroid and L-asparaginase on hyperglycemia in children with acute lymphoblastic leukemia (ALL)
AU - Aisyi, Mururul
AU - Andriastuti, Murti
AU - Kurniati, Nia
N1 - Funding Information:
The authors thanks to dr. Endang windiastuti, SpA(K) and Prof. dr. Djajadiman Gatot, Sp.A(K) from the Hematology Oncology division Departments of Child Health Universitas Indonesia. The authors also acknowledges DR.dr. Satria Pratama, SpP and dr. Umi Fajriati for their assistance This work was supported by Dharmais Cancer Hospital Funding.
Publisher Copyright:
© 2019 Asian Pacific Organization for Cancer Prevention.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Hyperglycaemia is a common side effect of steroid and L-asparaginase combinations, occurring most often during acute lymphoblastic leukemia (ALL) induction phase. To date in Indonesia, it has not been obtained data on the incidence of hyperglycemia in children with ALL in the induction phase and how the role of combinations of L-asparaginase and different type of steroid used. The purpose of this study is to determine the incidence of hyperglycemia in children ALL induction phase, knowing the difference between prednisone and dexamethasone (in combination with L-asparaginase) in causing hyperglycemia in children with ALL and determine the relationship of other factors related to hyperglycaemia. Methods: This was a prospective analytic study with a pre- and post-test design, conducted in three hospitals (Cipto Mangunkusumo Hospital, Dharmais Cancer Hospital, and Gatot Soebroto Hospital). Patient's blood glucose levels were checked at the 3rd (pretest), 4th, 5th and 6th week of protocol (post-test). Result: Of the 57 patients, 5.26% had hyperglycemia. The patients' age ranged from 1.4 years old to 15.8 years old (6.7 years old). There was no relationship between age, CNS infiltration, leukocytosis, Down syndrome, nutritional status, family history of diabetes, infections and ALL stratification with hyperglycemia (p > 0.05). Dexamethasone has more chance of obtaining higher mean rate of change in blood glucose levels compared to prednisone. (p < 0.05; RR 10.68; CI 95% 1.52-74.73). Conclusion: The incidence of hyperglycemia in this study is 5.26%. Dexamethasone, in combination with L-asparaginase, despite having no difference in causing hyperglycemia, has an increased risk of changing blood glucose levels compared to prednisone.
AB - Background: Hyperglycaemia is a common side effect of steroid and L-asparaginase combinations, occurring most often during acute lymphoblastic leukemia (ALL) induction phase. To date in Indonesia, it has not been obtained data on the incidence of hyperglycemia in children with ALL in the induction phase and how the role of combinations of L-asparaginase and different type of steroid used. The purpose of this study is to determine the incidence of hyperglycemia in children ALL induction phase, knowing the difference between prednisone and dexamethasone (in combination with L-asparaginase) in causing hyperglycemia in children with ALL and determine the relationship of other factors related to hyperglycaemia. Methods: This was a prospective analytic study with a pre- and post-test design, conducted in three hospitals (Cipto Mangunkusumo Hospital, Dharmais Cancer Hospital, and Gatot Soebroto Hospital). Patient's blood glucose levels were checked at the 3rd (pretest), 4th, 5th and 6th week of protocol (post-test). Result: Of the 57 patients, 5.26% had hyperglycemia. The patients' age ranged from 1.4 years old to 15.8 years old (6.7 years old). There was no relationship between age, CNS infiltration, leukocytosis, Down syndrome, nutritional status, family history of diabetes, infections and ALL stratification with hyperglycemia (p > 0.05). Dexamethasone has more chance of obtaining higher mean rate of change in blood glucose levels compared to prednisone. (p < 0.05; RR 10.68; CI 95% 1.52-74.73). Conclusion: The incidence of hyperglycemia in this study is 5.26%. Dexamethasone, in combination with L-asparaginase, despite having no difference in causing hyperglycemia, has an increased risk of changing blood glucose levels compared to prednisone.
KW - ALL induction phase
KW - Hyperglycemia
KW - L-asparaginase
KW - Steroid
UR - http://www.scopus.com/inward/record.url?scp=85072662397&partnerID=8YFLogxK
U2 - 10.31557/APJCP.2019.20.9.2619
DO - 10.31557/APJCP.2019.20.9.2619
M3 - Article
C2 - 31554355
AN - SCOPUS:85072662397
SN - 1513-7368
VL - 20
SP - 2619
EP - 2624
JO - Asian Pacific Journal of Cancer Prevention
JF - Asian Pacific Journal of Cancer Prevention
IS - 9
ER -