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评估小儿急性淋巴细胞白血病诱导治疗期间药物性糖尿病的风险分类

Assessing Risk Classification in Medication-Induced Diabetes during Induction Therapy in Pediatric Acute Lymphoblastic Leukemia.

作者信息

Ross Katie, Kulkarni Ketan, MacDonald Tamara, Pinto Teresa

机构信息

Faculty of Medicine, Dalhousie University, Halifax B3H 4R2, Canada.

Division of Hematology/Oncology, Department of Pediatrics, IWK Health, Halifax B3K 6R8, Canada.

出版信息

Pediatr Diabetes. 2023 Dec 16;2023:1057639. doi: 10.1155/2023/1057639. eCollection 2023.

Abstract

Medication-induced diabetes (MID) is common during induction therapy for pediatric acute lymphoblastic leukemia (ALL) and has potentially significant negative consequences. Reported risk factors for MID are variable with limited data comparing patients treated with standard-risk (SR) vs. high-risk (HR) regimens. This study aims to evaluate the incidence and risk factors for MID during induction in patients with ALL from the Maritimes over a 20-year period. We performed a retrospective single-center study of 262 patients (142 males, 120 females) diagnosed with ALL at IWK Health in Halifax, Nova Scotia, Canada, from 2000 to 2019. Older age, higher body mass index, greater central nervous system status, Trisomy 21, and prednisone steroid type were risk factors associated with MID in our cohort. HR patients developed significantly more complications than SR patients including MID and infection. Screening for MID should be routine during ALL induction treatment, particularly in those with HR disease.

摘要

药物性糖尿病(MID)在儿童急性淋巴细胞白血病(ALL)诱导治疗期间很常见,并且可能产生重大的负面后果。报道的MID危险因素各不相同,比较标准风险(SR)与高风险(HR)方案治疗患者的数据有限。本研究旨在评估20年间来自沿海地区的ALL患者诱导治疗期间MID的发生率和危险因素。我们对2000年至2019年在加拿大新斯科舍省哈利法克斯市IWK健康中心诊断为ALL的262例患者(142例男性,120例女性)进行了一项回顾性单中心研究。在我们的队列中,年龄较大、体重指数较高、中枢神经系统状态较高、21三体综合征和泼尼松类固醇类型是与MID相关的危险因素。HR患者比SR患者出现更多并发症,包括MID和感染。在ALL诱导治疗期间,特别是患有HR疾病的患者,应常规筛查MID。

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本文引用的文献

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