Effect of different asparaginase on the incidence of drug-induced diabetes in children with acute lymphoblastic leukemia during combined chemotherapy / 中国基层医药

ABSTRACT

Objective:To observe the effect of different asparaginase on the incidence of drug-induced diabetes in children with acute lymphoblastic leukemia(ALL) during combined chemotherapy.Methods:A total of 100 ALL children hospitalized in Zhucheng People's Hospital from January 2016 to December 2018 were selected in this study.According to the difference of asparaginase, 67 cases were divided into L-asparaginase group, and 33 cases were divided into pegaspargase group.The demographic, clinical indicators and remission after chemotherapy were compared between the two groups, and logistic regression model was used to analyze the influencing factors of diabetes mellitus during treatment.Results:There were statistically significant differences in random blood glucose ( t=2.515, P=0.014), albumin ( t=2.407, P=0.018), serum C-peptide ( t=2.030, P=0.045) and diabetes mellitus ( t=5.380, P=0.002) between the two groups after chemotherapy ( P<0.05). During chemotherapy, drug-induced diabetes mellitus had the highest incidence in induction remission period.The incidence of the L-asparaginase group (31.3%, 21/67) was higher than that of the pegaspargase group (12.1%, 4/33) (χ 2=4.357, P=0.037). Age (χ 2=7.748, P=0.005), risk stratification (χ 2=10.500, P=0.005) and types of chemotherapeutic drugs (χ 2=7.752, P=0.005) were independent influencing factors for the occurrence of drug-induced diabetes in children with ALL during chemotherapy ( P<0.05). The older the age, the greater the risk of diabetes mellitus during chemotherapy.The risk of drug-induced diabetes mellitus in pegaspargase group was 0.107 times higher than that in L-asparaginase group.The risk of drug-induced diabetes in high-risk children was 9.916 times higher than that in low-risk children. Conclusion:Drug-induced diabetes mellitus in ALL children treated with asparaginase combined with chemotherapy mainly occurs in the early stage of chemotherapy.The risk of drug-induced diabetes mellitus in ALL children treated with L-asparaginase combined with chemotherapy is higher than that of pegaspargase.Pegaspargase combined with chemotherapy in the treatment of ALL children can effectively reduce the incidence of drug-induced diabetes during chemotherapy.