Protracted administration of L-asparaginase in maintenance phase is the risk factor for hyperglycemia in older patients with pediatric acute lymphoblastic leukemia

Hideki Yoshida, Toshihiko Imamura, Akiko M. Saito, Yoshihiro Takahashi, Soichi Suenobu, Daiichiro Hasegawa, Takao Deguchi, Yoshiko Hashii, Hirohide Kawasaki, Mikiya Endo, Hiroki Hori, Nobuhiro Suzuki, Yoshiyuki Kosaka, Koji Kato, Keiko Yumura-Yagi, Junichi Hara, Megumi Oda, Atsushi Sato, Keizo Horibe

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    Abstract

    Although L-asparaginase related hyperglycemia is well known adverse event, it is not studied whether the profile of this adverse event is affected by intensification of L-asparaginase administration. Here, we analyzed the profile of L-asparaginase related hyperglycemia in a 1,176 patients with pediatric acute lymphoblastic leukemia treated according to the Japan Association of Childhood Leukemia Study ALL-02 protocol using protracted L-asparaginase administration in maintenance phase. We determined that a total of 75 L-asparaginase related hyperglycemia events occurred in 69 patients. Although 17 events (17/1176,1.4%) developed in induction phase, which was lower incidence than those (10-15%) in previous reports, 45 events developed during the maintenance phase with protracted L-asparaginase administration. Multivariate analysis showed that older age at onset (≥ 10 years) was a sole independent risk factor for L-asparaginase-related hyperglycemia (P<0.01), especially in maintenance phase. Contrary to the previous reports, obesity was not associated with L-asparaginase-related hyperglycemia. These findings suggest that protracted administration of L-asparaginase is the risk factor for hyperglycemia when treating adolescent and young adult acute lymphoblastic leukemia patients.

    Original languageEnglish
    Article numbere0136428
    JournalPloS one
    Volume10
    Issue number8
    DOIs
    Publication statusPublished - Aug 28 2015

    All Science Journal Classification (ASJC) codes

    • Biochemistry, Genetics and Molecular Biology(all)
    • Agricultural and Biological Sciences(all)
    • General

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  • Cite this

    Yoshida, H., Imamura, T., Saito, A. M., Takahashi, Y., Suenobu, S., Hasegawa, D., Deguchi, T., Hashii, Y., Kawasaki, H., Endo, M., Hori, H., Suzuki, N., Kosaka, Y., Kato, K., Yumura-Yagi, K., Hara, J., Oda, M., Sato, A., & Horibe, K. (2015). Protracted administration of L-asparaginase in maintenance phase is the risk factor for hyperglycemia in older patients with pediatric acute lymphoblastic leukemia. PloS one, 10(8), [e0136428]. https://doi.org/10.1371/journal.pone.0136428