Steroid-containing Chemotherapy Can Induce Diabetes in DLBCL

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Glucocorticoid-containing chemotherapy may induce diabetes mellitus or worsen glucose control among patients with diffuse large B cell lymphoma.
Glucocorticoid-containing chemotherapy may induce diabetes mellitus or worsen glucose control among patients with diffuse large B cell lymphoma.
The following article features coverage from the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference in Anaheim, California. Click here to read more of Cancer Therapy Advisor's conference coverage.

Glucocorticoid-containing chemotherapy may induce diabetes mellitus or worsen glucose control among patients with diffuse large B cell lymphoma (DLBCL), according to a poster presented at the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference.1

DLBCL is commonly treated with R-CHOP, which includes 5 days of high-dose prednisone in each cycle. High-dose glucocorticoid use is associated with diabetes mellitus. The purpose of this study was to evaluate the incidence of diabetes and clinical outcomes among patients with DLBCL.

The retrospective study included 134 patients with DLCBCL — of whom 16 had a prior history of diabetes — who received glucocorticoid-containing chemotherapy between 2009 and 2014. About 55% of patients were male, and 92% received R-CHOP.

Glucocorticoid-induced diabetes mellitus was diagnosed in 6.4% of patients, which occurred in 20% at the first cycle, 20% by the third cycle, and 60% by the sixth cycle of therapy.

Steroid administration prior to chemotherapy was significantly associated with the development of glucocorticoid-induced diabetes in a univariate analysis (P = .044).

There was no association with older age, sex, smoking history, body mass index, and prediabetes prior to treatment, as well as serum levels of triglycerides, low-density lipoprotein, or total cholesterol.

Among the 11 patients with prior diabetes, HbA1c increased in 8 patients and 2 patients needed additional insulin for glucose control.

RELATED: Venetoclax is Well Tolerated, Active in Non-Hodgkin Lymphoma

The results of this study indicate that glucocorticoid-containing chemotherapy may induce diabetes mellitus or exacerbate existing diabetes. The authors suggested that “more frequent plasma glucose monitoring may be considered.”

Read more of Cancer Therapy Advisor's coverage of the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference by visiting the conference page.

Reference

  1. Chu MH, Lo KY, Zhou K. Incidence and risk factors of glucocorticoid-induced diabetes mellitus in lymphoma patients treated with glucocorticoid-containing chemotherapy. Poster presented at: 13th Hematology/Oncology Pharmacy Association Annual Conference; March 29-April 1, 2017; Anaheim, CA. 

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