Characteristics of chemotherapy-induced diabetes mellitus in acute lymphoblastic leukemia patients
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Suo et al. / J Zhejiang Univ-Sci B (Biomed & Biotechnol) 2020 21(9):740-744
Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology) ISSN 1673-1581 (Print); ISSN 1862-1783 (Online) www.jzus.zju.edu.cn; www.springerlink.com E-mail: [email protected]
Correspondence:
Characteristics of chemotherapy-induced diabetes mellitus in acute lymphoblastic leukemia patients*# Shan-shan SUO1,2,3, Chen-ying LI1,2,3, Yi ZHANG1,2,3, Jing-han WANG1,2,3, Yin-jun LOU1,2,3, Wen-juan YU1,2,3, Jie JIN†‡1,2,3 1
Department of Hematology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China 2 Institute of Hematology, Zhejiang University, Hangzhou 310003, China 3 Zhejiang Province Key Laboratory of Hematology Oncology Diagnosis and Treatment, Hangzhou 310003, China † E-mail: [email protected] https://doi.org/10.1631/jzus.B1900719
Acute lymphocytic leukemia (ALL) is one of the most common malignancies, especially in young people. Combination chemotherapy for ALL typically includes corticosteroids (Kantarjian et al., 2000). Hyperglycemia is a well-recognized complication of corticosteroids, and chemotherapy-induced diabetes (CID) is not uncommon (27.5%–37.0%) during the treatment of ALL (Hsu et al., 2002; Weiser et al., 2004; Alves et al., 2007). Besides the effect of corticosteroids, potential factors triggering hyperglycemia in ALL also include direct infiltration of the pancreas by leukemia cells and β cell dysfunction induced by chemotherapeutic agents such as L-asparagine (Mohn et al., 2004). Several studies have noted alteration in glucose metabolism during the treatment of ALL (Koltin et al., 2012; Gifford et al., 2013; Banihashem et al., 2014), ‡
Corresponding author Project supported by the Zhejiang Provincial Natural Science Foundation of China (No. LY19H080009) # Electronic supplementary materials: The online version of this article (https://doi.org/10.1631/jzus.B1900719) contains supplementary materials, which are available to authorized users ORCID: Jie JIN, https://orcid.org/0000-0002-8166-9915 © Zhejiang University and Springer-Verlag GmbH Germany, part of Springer Nature 2020 *
but few studies have investigated the clinical significance of CID. Weiser et al. (2004) reported that patients with hyperglycemia (37%) had a shorter median complete remission duration and a shorter median survival. However, their study focused on selected populations (patients treated with the hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (Hyper-CVAD) regimen). Since patients using the Hyper-CVAD regimen represent only a small part of the patient population in clinical setting, it is not clear whether the prognostic value of CID has a rationale in all ALL patients. To further address this issue, we retrospectively investigated an unselected ALL population with several treatment regimens. We focused on an assessment of its characteristics, risk factors, and its prognostic value on survival. We collected data from 177 patients with newly diagnosed ALL in the d
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