Impact of Steroid-Induced Diabetes on Prognosis of Patients with Aggressive Lymphoid Malignancies: A Prospective Study

• Main Authors: Asmaa S. Othman, Manal A. Salah-Eldin, Mohamed A. Ebrahim, Sherin M. Abd EL-Aziz, Ahmed M. Ramez
• Format: Article
• Language: English
• Published: Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine 2021-06-01
• Series: Research in Oncology
• Subjects: complications; diabetes; lymphoid malignancies; prognosis; steroids
• Online Access: https://resoncol.journals.ekb.eg/article_158756_78e63e0908c0956d794d834584c1e92d.pdf
• ISSN: 2357-0687; 2357-0695

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.