The Effect of Hyperglycemia On the Outcome of Patients with Acute Myelogenous Leukemia

Hyperglycemia (HyG) has been shown to be detrimental in acute leukemia. In patients with acute myelogenous leukemia, hyG was associated with increased hospital mortality (Ali, et. al. Cancer 2007) while in patients with acute lymphocytic leukemia, hyG was associated with a shorter duration of complete response (CR) (Weiser et. al. Cancer 2004.) Our aim is to evaluate the effects of hyperglycemia on achievement of CR, disease free survival (DFS) and overall survival (OS) in patients with AML in our institution.

We retrospectively reviewed all patients diagnosed with AML from 1/1/2005 to 1/1/2012 who underwent initial induction chemotherapy with 7+3 at our institution. Responses were defined according to the 2003 International Working Group criteria as CR within 6 weeks or no response. HyG was defined as 2 or more serum blood glucose levels ≥ 200 in the 30 days following induction chemotherapy. OS was determined using the Kaplan Meier method and compared using the log rank test.

Of the 91 patients identified, 43 (47%) were female. The median age at diagnosis was 53 years old. The cytogenetic categories were good (15 patients, 17%), intermediate (44 patients, 50%), and poor (29 patients, 33%). The median OS for all patients was 321 days. Median OS in the good, intermediate and poor cytogentics group was 423 days, 314 days and 314 days respectively. HyG, as previously defined, was seen in 39 (43%) of patients. CR was achieved in 40 (44%) of patients within 6 weeks of induction. Of the 40 patients achieving CR within 6 weeks, 19 (48%) were HyG and 21 (52%) were normoglycemic (p=0.67). Median OS was 375 days in the normoglycemic group and 210 days in the HyG group (p=0.74). Of the patients achieving CR in 6 weeks, median DFS was 290 days in the normoglycemic group and 243 days in the HyG group (p=0.54).

Hyperglycemia in the post-induction period does not appear to have an impact on achievement of CR, DFS, or OS in the AML population.

No relevant conflicts of interest to declare.