Associação entre mortalidade e hiperglicemia, alterações das enzimas tissulares hepáticas, amilase e perfil lipídico em crianças e adolescentes com leucemia linfóide aguda

Abstract

AIM: to evaluate the occurrence of hyperglycemia and elevation of tissue hepatic enzymes, amylase and serum lipids in the Induction of Remission on treatment of pediatric patients with Acute Lymphoid Leukemia, associating these disorders to patients’ mortality rates in the induction of remission and in the post Induction. METHOD: this study was developed on the Oncology Pediatric Service of Dr. Osvaldo Leite Oncology Center, in Aracaju, Sergipe. A cohort study was made involving patients up to 19 years old with Acute Lymphoid Leukemia confirmed by immunophenotyping of bone marrow aspirate or peripheral blood sample between February 1, 2008 and October 30, 2016. Were collected laboratory tests in the Induction of Remission at each scheduled chemotherapy day: blood glucose at first (D1), eight (D8), fifteenth (D15), twenty-second (D22), twenty-eight (D28), thirty-fifth (D35) and forty-second (D42) treatment days; tissular hepatic enzymes, serum pancreatic amylase and serum lipids were evaluated at first (D1) and last Induction of Remission’s day (D42). RESULTS: about 15% of pacients with hyperglycemia in Induction of Remission died at this phase of treatment; among the remaining patients in post Induction, 41,7% died. Similar pattern happened to the deaths between those with tissular hepatic elevation in IR. Higher death percentages were observed in post Induction than in IR. Few amylase and serum lipids data were available, but as already described about blood glucose and tissular hepatic enzymes disorders, higher death rates in post Induction were found than in IR. CONCLUSION: may exist association among some metabolic change markers, mainly between early hyperglycemia and early tissular hepatic enzymes elevation, and late deaths (post Induction phase), what suggests the need of more frequent glucose levels and tissular hepatic enzymes monitoring in all treatment; this fact would allow a implementation of protection measures against this unfavorable outcome.