Abstract Ref Number = APCP927
INCREASING OF RANDOM BLOOD GLUCOSE LEVEL IN PEDIATRIC ACUTE LYMPHOBLASTIC LEUKEMIA AFTER L-ASPARGINASE ADMINISTRATION
Yuli Astika,andi cahyadi,maria christina shanty larasati,mia ratwita andarsini,I Dewa Gede Ugrasena,Bambang permono
Department of Child Health Faculty of Medicine Universitas Airlangga Dr Soetomo Hospital Surabaya Indonesia
Background : L-asparaginase was one of the main chemotherapy beside corticosteroid for pediatric acute lymphoblastic leukemia (ALL). L-asparaginase was associated with side effects of allergic reactions, hyperlipidemia, acute pancreatitis and metabolic abnormality. Previous study stated that L-asparginase can cause abnormality in blood glucose due to pancreas destruction. However, the side effect in blood glucose is still inconsistent, sometimes with hypoglycemia. We will determine the increasing of blood glucose before and after L-asparaginase administration in pediatric ALL.
Material : A cross sectional study was performed on pediatric ALL below 18 years old in Dr Soetomo Hospital Surabaya from Maret to April 2018 who got L-asparaginase intramuscular for induction phase of chemotherapy using Indonesian ALL protocol 2013; 7500 unit/m2 six times for standard risk and 7500 unit/m2 nine times for high risk protocol. Random blood glucose was evaluated before and after L-asparaginase administration using gluco-DR test stick (mg/dl). Paired test was used to analysis the data (? 0.05)
Results : A total of 25 children were included, 18/25 were boys. The median age was 4 (from 2 to 17) years. In overall group, random blood glucose was significant increase after L-asparaginase administration, from 88.1 (SD 10.20 mg/dL to 119.6 (SD 44.54) mg/dL (mean different 31.5 mg/dL; P=0.002). In high risk ALL group, the blood glucose was not significant different (P=0.241) but for standard risk group, the blood glucose significantly increased (mean different 29 mg/dL; P=0.005). Hyperglycemia (random blood glucose >200 mg/dL) occurred in 4 children (3 with ALL-SR and 1 with ALL-HR).
Conclusions : L-asparaginase administration can increase blood glucose in pediatric ALL especially in standard risk protocol
Keywords: Acute Lymphoblastic Leukemia L-Asparginase Random Blood Glucose