Büyükçelik et al. raise a valid question regarding the relation between hyperglycemia and dose reduction during chemotherapy with hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) for the treatment of acute lymphocytic leukemia. We reviewed the data and found that 62% of patients with hyperglycemia (defined as a random serum glucose level of ≥ 200 mg/dL on 2 or more determinations during the first 30 days of treatment) had a dose reduction at some time during treatment, compared with 60% of patients without hyperglycemia. Therefore, there does not appear to be an association between hyperglycemia and the risk for reduction in dose intensity in this patient population.


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    Weiser MA, Cabanillas ME, Konopleva M, et al. Relation between the duration of remission and hyperglycemia during induction chemotherapy for acute lymphoblastic leukemia with a hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone/methotrexate-cytarabine regimen. Cancer. 2004; 100: 11791185.