The impact of hyperglycemia on risk of infection and early death during induction therapy for acute lymphoblastic leukemia (ALL)

Authors

  • Julianne M Dare MBChB, BsC (Hons), MRCPCH,

    Corresponding author
    • Department of Haematology Oncology, Bristol Royal Hospital for Children, Bristol, United Kingdom
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  • John P Moppett MA, MBChB, MRCP, MRCPCH, FRPATH, PhD,

    1. Department of Haematology Oncology, Bristol Royal Hospital for Children, Bristol, United Kingdom
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  • Julian PH Shield MBChB, MD, MRCP, FRCPCH,

    1. School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
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  • Linda P Hunt BSc, MSc, PhD, MIS (later-CStat) Cert Ed (Tech),

    1. School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
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  • Michael CG Stevens MD, FRCP, FRCPCH, FRCR

    1. Department of Haematology Oncology, Bristol Royal Hospital for Children, Bristol, United Kingdom
    2. School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
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  • Conflict of Interest: Please report all conflicts of interest or state “nothing to report”—whichever is applicable.

Correspondence to: Dr Julianne Dare Paediatric Oncology, Level 6 UHB Education Centre, Upper Maudlin Street, Bristol BS2 8AE, United Kingdom.

E-mail: juliannedare@doctors.org.uk

Abstract

Hyperglycemia during induction chemotherapy for childhood acute lymphoblastic leukemia (ALL) has been inconsistently associated with risk of infection. We investigated the incidence of hyperglycemia during induction for childhood ALL in a retrospective cohort study of 144 patients treated on a single national protocol (UKALL2003) and explored its association with infection. All patients received dexamethasone. Overt hyperglycemia was seen in 36% and proven bacterial or fungal infection was most common in this group (OR 4.1 (1.1–15.6), P = 0.039). Both hyperglycaemia and infection were particularly common in patients with Down Syndrome. Pediatr Blood Cancer 2013;60:E157–E159. © 2013 Wiley Periodicals, Inc.

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