Othman, A., Salah-Eldin, M., Ebrahim, M., Abd EL-Aziz, S., Ramez, A. (2021). Impact of Steroid-Induced Diabetes on Prognosis of Patients with Aggressive Lymphoid Malignancies: A Prospective Study. Research in Oncology, 17(1), 31-37. doi: 10.21608/resoncol.2021.48233.1123
Asmaa S. Othman; Manal A. Salah-Eldin; Mohamed A. Ebrahim; Sherin M. Abd EL-Aziz; Ahmed M. Ramez. "Impact of Steroid-Induced Diabetes on Prognosis of Patients with Aggressive Lymphoid Malignancies: A Prospective Study". Research in Oncology, 17, 1, 2021, 31-37. doi: 10.21608/resoncol.2021.48233.1123
Othman, A., Salah-Eldin, M., Ebrahim, M., Abd EL-Aziz, S., Ramez, A. (2021). 'Impact of Steroid-Induced Diabetes on Prognosis of Patients with Aggressive Lymphoid Malignancies: A Prospective Study', Research in Oncology, 17(1), pp. 31-37. doi: 10.21608/resoncol.2021.48233.1123
Othman, A., Salah-Eldin, M., Ebrahim, M., Abd EL-Aziz, S., Ramez, A. Impact of Steroid-Induced Diabetes on Prognosis of Patients with Aggressive Lymphoid Malignancies: A Prospective Study. Research in Oncology, 2021; 17(1): 31-37. doi: 10.21608/resoncol.2021.48233.1123
Impact of Steroid-Induced Diabetes on Prognosis of Patients with Aggressive Lymphoid Malignancies: A Prospective Study
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.