Objectives Chronic metabolic disturbances related to cancer treatment are well reported among survivors of pediatric acute lymphoblastic leukemia (ALL). However, few studies have investigated the incidence of these complications during the phase of chemotherapy. We evaluated the incidence of acute metabolic complications occurring during therapy in our cohort of patients diagnosed with ALL. Methods A prospective study involving 50 ALL pediatric patients diagnosed and treated between 2012 and 2016 in our oncology unit. We collected weight, blood pressure, fasting plasma glucose and hemoglobin A1C (HBA1c) levels during the two years of therapy. Results Obesity and overweight occurred in 43 and 25%, respectively among patients and have been reached at 12 months of chemotherapy. About 26% of the patients developed high blood pressure and 14% experienced hyperglycemias without meeting diabetes criteria. There was a significant decrease of HBA1c levels between the beginning and the end of therapy (p<0.0001). Conclusions Increase of body mass index in our ALL pediatric patients occurred during the first months of therapy and plateaued after a year of treatment. We should target this population for early obesity prevention. HbA1c levels measured during therapy did not reveal diabetes criteria. Hence, fasting blood glucose levels are sufficient to monitor ALL pediatric patients’ glycemia.

中文翻译：

---

儿童急性淋巴细胞白血病治疗期间无症状糖尿病和代谢合并症的筛查

目的 与癌症治疗相关的慢性代谢紊乱在儿科急性淋巴细胞白血病 (ALL) 的幸存者中得到了广泛的报道。然而，很少有研究调查化疗阶段这些并发症的发生率。我们评估了我们诊断为 ALL 的患者队列治疗期间发生的急性代谢并发症的发生率。方法 一项前瞻性研究，涉及 2012 年至 2016 年间在我们的肿瘤科诊断和治疗的 50 名 ALL 儿科患者。我们收集了两年治疗期间的体重、血压、空腹血糖和血红蛋白 A1C (HBA1c) 水平。结果 肥胖和超重分别发生在 43% 和 25% 的患者中，并且在化疗 12 个月时已经达到。大约 26% 的患者出现了高血压，14% 的患者出现了不符合糖尿病标准的高血糖症。HBA1c 水平在治疗开始和结束之间显着降低（p<0.0001）。结论 ALL 儿科患者的体重指数增加发生在治疗的前几个月，并在治疗一年后趋于稳定。我们应该针对这一人群进行早期肥胖预防。治疗期间测量的 HbA1c 水平未显示糖尿病标准。因此，空腹血糖水平足以监测所有儿科患者的血糖。结论 ALL 儿科患者的体重指数增加发生在治疗的前几个月，并在治疗一年后趋于稳定。我们应该针对这一人群进行早期肥胖预防。治疗期间测量的 HbA1c 水平未显示糖尿病标准。因此，空腹血糖水平足以监测所有儿科患者的血糖。结论 ALL 儿科患者的体重指数增加发生在治疗的前几个月，并在治疗一年后趋于稳定。我们应该针对这一人群进行早期肥胖预防。治疗期间测量的 HbA1c 水平未显示糖尿病标准。因此，空腹血糖水平足以监测所有儿科患者的血糖。