Hiperglicemia en niños con leucemia linfoblástica aguda en tratamiento con L-asparaginasa

Abstract

Introduction: L-asparaginase (L-asp) is an antineoplastic agent that has among its adverse reactions, hyperglycemia. Each insulin molecule has three asparagine residues which are hydrolyzed by L-asp, decreasing insulin synthesis and resulting in hyperglycemia. The objective of this study is to describe the characteristics of hyperglycemia associated with the use of L-asp in children with Acute Lymphoblastic Leukemia (ALL). Patients and Method: A retrospective study that included review of medical records of all children admitted to Valdivia Center of the National Children's Antineoplastic Drug Program, between 2002 and 2009 was performed. Patient backgrounds were evaluated and those who were suspected to present adverse drug reactions were evaluated according to the causality classification of Karch and Lasagna. Results: 85 of 102 patients who met the inclusion criteria entered the study. The incidence of hyperglycemia was 6.74%. The patients with hyperglycemia were those older than 9.5 years of age, with risk of obesity, diabetes, family history of diabetes mellitus and concomitant corticosteroid treatment. Conclusion: The characteristics of hyperglycemia in patients treated with L-asp coincide with those of the literature. Simultaneous administration of corticosteroids and L-asp make difficult to determine causality of L-asp, so further research is needed.