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. 2023 Nov 28;30(12):10142-10151.
doi: 10.3390/curroncol30120738.

Steroid-Induced Hyperglycemia and Its Effect on Outcomes of R-CHOP Chemotherapy for Diffuse Large B-Cell Lymphoma

Mark Kristjanson  1   2 , Pascal Lambert  3   4 , Kathleen M Decker  3   4   5 , Sonja Bruin  6 , Elizabeth Tingey  7 , Pamela Skrabek  8   9
Affiliations

Steroid-Induced Hyperglycemia and Its Effect on Outcomes of R-CHOP Chemotherapy for Diffuse Large B-Cell Lymphoma

Mark Kristjanson et al. Curr Oncol. .

Abstract

Large doses of steroids are integral to R-CHOP, a first-line systemic therapy for diffuse large B-cell lymphoma (DLBCL), an aggressive form of non-Hodgkin Lymphoma (NHL). Patients on R-CHOP often develop clinically significant hyperglycemia from steroids. There is evidence of harms from steroid-induced hyperglycemia in the context of chemotherapy which are associated with a reduction in overall survival. The objective of our study was to characterize the effect of steroid-induced hyperglycemia on the outcomes of R-CHOP chemotherapy for DLBCL.

Methods: We performed a retrospective chart review of 188 patients with DLBCL treated with R-CHOP through CancerCare Manitoba (CCMB) from 1 January 2010 to 31 December 2014. Patients diagnosed with DLBCL were identified using the Manitoba Cancer Registry. The CCMB electronic medical record was reviewed to examine the association between steroid-induced hyperglycemia and subsequent infection, including febrile neutropenic events and overall survival (OS).

Results: Patients who developed hyperglycemia with steroid exposure became hyperglycemic during their first R-CHOP cycle. No significant differences in OS or rates of infection were found between euglycemic and hyperglycemic subjects.

Conclusions: Patients destined to develop steroid-induced hyperglycemia declare themselves early in the course of steroid exposure. No statistically significant reduction in overall survival attributable to steroid-induced hyperglycemia was found.

Keywords: hyperglycemia; lymphoma; steroid; toxicities.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Mean blood glucose levels (mmol/L) for two distinct clusters (a euglycemic group and a hyperglycemic group) by month during the first year of follow-up post chemotherapy initiation.
Figure 2
Figure 2
Overall survival between the euglycemic group and the hyperglycemic group by year 1 year post chemotherapy initiation.
Figure 3
Figure 3
Blood glucose levels (mmol/L) for two distinct clusters (a euglycemic group and a hyperglycemic group) by month during the first year of follow-up post chemotherapy initiation.
Figure 4
Figure 4
Predicted infection—free probabilities by trajectory groups (association parameter from joint latent class mixed model.
Figure 5
Figure 5
Predicted infection-free probabilities after mean blood glucose during first month of follow-up.
See this image and copyright information in PMC

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