Impact of Steroid-Induced Diabetes on Prognosis of Patients with Aggressive Lymphoid Malignancies: A Prospective Study | ||||
| Research in Oncology | ||||
| Article 5, Volume 17, Issue 1, June 2021, Page 31-37 PDF (227.11 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/resoncol.2021.48233.1123 | ||||
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| Authors | ||||
Asmaa S. Othman1; Manal A. Salah-Eldin1; Mohamed A. Ebrahim1; Sherin M. Abd EL-Aziz2; Ahmed M. Ramez   1
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| 1Department of Medical Oncology, Faculty of Medicine, Mansoura University, Mansoura, Egypt | ||||
| 2Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt | ||||
| Abstract | ||||
| Background: Hyperglycemia is frequent during steroid therapy and thus it is not uncommon during treatment of lymphoid malignancies. Steroid-induced diabetes (SID) can be complicated by an increased risk of infections, lower chemotherapy efficacy, and even increased mortality. Aim: To determine the prevalence of SID in patients with aggressive lymphoid malignancies during induction therapy and to analyze its impact on treatment outcomes. Methods: The study included 52 patients with lymphoid malignancies; 28 with acute lymphoblastic leukemia (ALL) and 24 with aggressive non-Hodgkin’s lymphomas (NHL). We studied the relation between the development of SID during induction therapy and the rates of complete remission (CR), complication and relapse and survival. Results: Steroid-induced diabetes occurred during induction therapy in 18/28 (64%) and 8/24 (33%) of patients with ALL and NHL, respectively. Older age, and elevated bilirubin level were significantly associated with the development of SID during induction therapy in ALL patients (p = 0.02 and 0.005, respectively), while only older age showed a significant association in NHL patients (p = 0.002). Compared with patients who did not develop SID, those with SID had significantly higher prevalence of febrile neutropenia in the ALL group (p = 0.001) and pneumonia in the NHL group (p = 0.009). Both ALL and NHL patients with SID were significantly less likely to achieve CR and had a significantly worse overall survival. Conclusion: The results of this study suggest that SID is frequent during induction therapy in patients with lymphoid malignancies and associated with more complications and worse treatment outcomes. | ||||
| Keywords | ||||
| Complications; Diabetes; Lymphoid malignancies; Prognosis; Steroids | ||||
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