Acute endocrine and metabolic complications during treatment in childhood acute lymphoblastic leukemia patients: Retrospective study

Abstract

Introduction: Acute leukemias are the most common malignancy of childhood, and acute lymphoblastic leukemia (ALL) is the most common subtype. In this study; we aimed to asses to acute endocrine and metabolic complications which occurs during treatment. Newly diagnosed ALL patients were included in the study.Materials and Methods: The endocrine and metabolic complication of 293 patients aged 1-18 years old who were newly diagnosed ALL between January 2007 and December 2017 in Uludag University Faculty, Department of Pediatric Hematology were analyzed. Patients' age, gender, risk groups, leukemia subtypes, and chemotherapy phases at the time of endocrine complications were noted.Results: In total, 250 patients were follow-up with B-ALL and 43 patients with T-ALL. 64% (n=188) of patients were male and 36% (n=105) were female. In our study, 36.4% of patients were in the high risk group but ten of the patients died before the risk group could be determined. During the two-year treatment, We found that 83% of the patients developed at least one endocrine complication. Hyperglycemia, osteoporosis and avascular necrosis were observed more frequently in patients older than 10 years at the time of diagnosis. The difference between the sexes was found only in vitamin D and was lower in girls. In regression analysis, only to be high risk group were found to be effective for the development of endocrine complications.Conclusion: Although the chemotherapeutics used today have prolonged the survival time, they have caused an increase in the incidence of complications. We think that these complications can be reduced by determining the risk factors in advance.