Approximately 4% to 35% of pediatric patients undergoing treatment for
acute lymphoblastic leukemia (ALL) and
lymphoblastic lymphoma (LLy) develop
drug-induced
hyperglycemia. Though
hyperglycemia is associated with poor outcomes, no guidelines for identifying
drug-induced
hyperglycemia currently exist, and the time course for developing
hyperglycemia remains relatively uncharacterized after induction
therapy. The present study evaluated a
hyperglycemia screening protocol that was implemented to identify
hyperglycemia more promptly, examined predictors of
hyperglycemia during ALL and LLy
therapy, and described the timeline for developing
hyperglycemia. A retrospective review of 154 patients diagnosed with ALL or LLy at Cook Children's Medical Center between March 2018 and April 2022 was performed. Predictors of
hyperglycemia were examined with Cox regression. The
hyperglycemia screening protocol was ordered for 88 (57%) patients. Fifty-four (35%) patients developed
hyperglycemia. In multivariate analyses, age 10 years or older (hazard ratio = 2.50, P = 0.007) and
weight loss (vs gain) during induction (hazard ratio = 3.39, P < 0.05) were associated with
hyperglycemia. The present study identified a population of patients at risk of developing
hyperglycemia and identifies strategies for
hyperglycemia screening. In addition, the present study showed that some patients developed
hyperglycemia after induction
therapy, which highlights the importance of continued
blood glucose monitoring in at-risk patients. Implications and suggestions for further research are discussed.