Hyperglycemia Linked To Hospital Mortality In AML Patients

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Acute Myeloid Leukemia

Scientists may have found an association between high blood sugar levels and death during hospitalization in patients with the most common type of adult leukemia.

Researchers at the Ohio State University Medical Center studied the outcomes of 283 patients diagnosed with acute myeloid leukemia and found them to be at an increased risk for developing sepsis and then dying, even when modest levels of sugar were present in the bloodstream.

The study will appear in the July issue of the journal CANCER.

"Hyperglycemia is common in medically ill patients and previous studies have shown an association with infection and shorter disease-free survival in other groups of cancer patients," says Dr. Naeem Ali, a critical care specialist at OSU Medical Center's Center for Critical Care and Respiratory Medicine. "We wanted to see if this same link existed in patients with AML.

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"The findings show that glucose regulation in patients under significant medical stress and at risk for infection affect their medical outcome," says Ali, principal investigator of the study.

In observing outcomes over three years, the researchers found a rise in mortality, evident even at mild levels of glucose elevation. Although the odds of developing severe sepsis increased with high glucose levels, sepsis did not appear to be the main contributor for the negative impact of hyperglycemia on hospital mortality.

"This is particularly important because severe infection is one of the most common reasons that patients with acute myeloid leukemia die or have their chemotherapy limited," adds Dr. William Blum, an oncologist at Ohio State's James Cancer Hospital and Solove Research Institute and researcher who collaborated on this study.

Over 11,000 people a year are diagnosed with acute myeloid leukemia. The disease occurs when cancerous immature blood cells replace normal blood cells in the bone marrow and other tissues. Seventy-five percent of those diagnosed with the disease will die within five years because of increased risk of infection. In advanced cases, the odds are higher for patients to develop sepsis, when the infection causes the failure of critical organs, and this can lead to an increase in other illnesses and death.

Patients under medical stress often have hyperglycemia, an abnormally high concentration of glucose in the bloodstream. Other studies have shown that aggressive management of hyperglycemia in critically ill patients improves survival, reduces infections and decreases complications.

"Further research is necessary to confirm the link between hospital mortality and modest levels of hyperglycemia in patients with this type of leukemia, and to determine what exactly causes this effect," Ali adds.

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