Influence Of Pegaspargase On Glycometabolism Of Children With Acute Lymphoblastic Leukemia

Objective: Lymphatic tumor is a malignant tumor that is more commom in childhood.Acute lymphoblastic leukemia accounts for a large proportion,it seriously affects children's physical and mental health.Combined chemotherapy is an effective treatment for this tumor.Because pegaspargase is effective in treating acute lymphoblastic leukemia in children,it has become an important drug for the treatment of the disease,it can prolong the patient's survival time and improve the possibility of clinical remission.PEG-ASP has been widely used in clinic,The safety of its medication has gradually attracted people's attention.The purpose of this study is to investigate the dynamic changes of blood glucose levels after the treatment of acute lymphoblastic leukemia,to explore the related factors that cause blood sugar changes,and to guide clinical safety medication.Methods:Retrospective analysis of 127 patients with ALL in our hospital with the application of pegaspargase,from March 2015 to December 2017.According to the different chemotherapy stages,the remission induction group was group A,the intensive treatment group was group B,including 80 in group A and 47 in group B.Observe the fasting plasma glucose during use PEG-ASP.For patients who with hyperglycemia,through diet control and ues short-term insulin to reduce blood sugar when necessary,Monitor blood glucose dynamically until it reaches normal levels.To analyze the changes of blood glucose before and after administration,and the relationship between the occurrence of secondary hyperglycemia with age,sex and different chemotherapy stages.Results: Two groups of patients at different treatment stages after using PEG-ASP can lead to different levels of changes in blood sugar,Secondary hyperglycemia occurred earlier in the remission group.The incidence of Secondary hypeiglycemia in intensive group is higher than the remission group.Secondary hypeiglycemia has nothing to do with gender and is associated with age.Older children are more likely to have hyperglycemia.Hypeiglycemia was temporary and transient.All patients with highblood glucose levels have normal blood glucose levels.None of them had ketoacidosis.Conclusions:PEG-ASP can lead to changes in blood sugar.Secondary hyperglycemia happen end after medication day 6-8,older children tend to have high blood sugar levels than younger children.Sex is not related to Secondary hyperglycemia.The incidence and duration of Secondary hypeiglycemia in intensive group is higher than the remission group.All patients with high blood glucose levels have normal blood glucose levels through diet control and dynamic monitoring of blood glucose.None of them had ketoacidosis.Long-term follow-up should be done,the aim is to observe the future risk of reduced glucose tolerance or drug-induced diabetes,improve long-term survival and living quality.