Risk for type 2 diabetes mellitus may be elevated among adult survivors of childhood acute lymphoblastic leukemia (ALL), according to a recent report published in Cancer.

“As the survival rate for childhood ALL continues to improve, it is important to investigate late-effect health outcomes in this aging population,” noted the researchers.

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The study included a retrospective analysis of records from the St Jude Lifetime Cohort Study of adults with at least 10 years of survival following a diagnosis of childhood ALL. Results of clinical assessments and questionnaires were compared between survivors of ALL (1044 patients) and a control population (368 individuals).

The mean age of ALL survivors was 33.97 years; for the control group, mean age was 35.33 years. Among survivors of ALL, the prevalence of type 2 diabetes mellitus was 7.47%. This rate was significantly higher compared with the rate of 3.80% found in the control population. When adjusting for body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), the odds ratio (OR) for development of type 2 diabetes mellitus was 2.07 (95% CI, 1.11-3.87; P =.02) among survivors of ALL compared with the control population.

The rate of prediabetes was also higher among survivors of ALL (26.53%) compared with the control population (18.48%; P =.002), and drug-induced diabetes mellitus  occurred in 7.85% of the survivor group during treatment for ALL.

Multiple factors were associated with enhanced rates of type 2 diabetes mellitus among survivors of ALL in models adjusted with a BMI of below 25 as the reference condition. These risk factors included a BMI of 30 or more (adjusted OR, 7.40; 95% CI, 2.61-20.97; P <.001), drug-induced diabetes mellitus during ALL treatment (adjusted OR, 4.67; 95% CI, 2.53-8.61; P <.001), and age (adjusted OR, 1.05 per added year; 95% CI, 1.02-1.08; P <.001).

“The high prevalence and increased risk for diabetes among survivors of ALL in the St Jude LIFE cohort, combined with the potentially modifiable risk for diabetes, underscores the importance of surveillance and early interventions among survivors,” the researchers wrote.

Reference

  1. Williams HE, Howell CR, Chemaitilly W, et al. Diabetes mellitus among adult survivors of childhood acute lymphoblastic leukemia: A report from the St. Jude lifetime cohort study [published online November 12, 2019]. Cancer. doi:10.1002/cncr.32596