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Risk Factors for Hyperglycemia in Children with Leukemia Receiving L-asparaginase

Journal of the Korean Pediatric Society 1994;37(6):740-745.
Published online June 15, 1994.
Risk Factors for Hyperglycemia in Children with Leukemia Receiving L-asparaginase
Min Joong Kwon, Ho Sung Kim, Kir Young Kim, Duk Hi Kim
Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea
L-Asparaginase에 의해 유발된 고혈당증의 발생 위험 인자
권민중, 김호성, 김길영, 김덕희
연세대학교 의과대학 소아과학교실
Abstract
Hyperglycemia is a well-recognized side effect of L-asparaginase in remission induction therapy of acute lymphocytic leukemia. Since hyperglycemia has preceded fatal diabetic ketoacidosis or hyperosmotic nonketotic coma in some patients, early detection and treatment of this complication are important. We determined retrospectively the risk of hyperglycemia in 117 patients with leukemia who had received L-asparaginase (& prednisolone). The results were as follows: 1) Twenty (17%) of the 117 patients developed hyperglycemia. 2) Of 47 female patients, 13 developed hyperglycemia, contrast with only 7 of 70 male patients (p<0.05). 3) All 2 obese patients developed hyperglycemia, contrast with 18 of 115 non obese patients (p<0.05). 4) Of 16 patients with a history of previous administration of L-asparaginase 6 (42%) developed hyperglycemia, contrast with only 14 (11%) of the remaining 101 patients (p<0.05). 5) Of the remaining factors analyzed-age, leukocyte counts, family history, dose of L-asparaginasenon had a statistically important influence on the development of hyperglycemia. 6) The mean glucose concentration at onset was 355197.5mg/dl in patient who developed hyperglycemia with peak concentration of 404253.6mg/dl. Hyperglycemia developed between 3 to 20 days after administration of L-asparaginase, and the duration of hyperglycemia was 6.905.54 days. Since hyperglycemia developed inevitably in a certain proportion of patients given L-asparaginase, we recommend blood glucose monitoring in patients with the risk factors.
Key Words: Hyperglycemia, L-asparaginase


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