Acute endocrine and metabolic complications during treatment in childhood acute lymphoblastic leukemi apatients: Retrospective study

Acute leukemias are the most common malignancy of childhood, and acute lymphoblastic leukemia (ALL) is the most common subtype. İn this study we aimed to asses to acute endocrine and metabolic complications which occurs during treatment. Newly diagnosed ALL patients were included in the study. The endocrine and metabolic complication of 293 patients aged 12- 213 months who were newly diagnosed with ALL between January 2007 - December 2017 in Uludağ University Faculty, Department of Pediatric Hematology were analyzed comparatively. In total, 250 patients were followed up with B ALL and 43 patients with T ALL. 64% (n:188) of patients were male and 36 % (n:105) were female. 36,4% of patients were in the high risk group but about 3,4% of the patients died before the risk group could be determined. We found 83% of the patients who developed at least one endocrine complication during the treatment that lasted for 2 years.The most common complication is hyperparathyroidism. This is followed by hyperglycemia, hypertriglyceridemia, osteoporosis, thyroid pathologies, obesity, hypocalcemia, low vitamin D, hypoglycemia and avascular necrosis. Hyperglycemia, osteoporosis and avascular necrosis were observed more frequently in patients older than 10 yeasr at the time of diagnosis. Hyperglicemia, thyroid pathology and avascular necrosis were higher in pubertal patients than in prepubertal patients. The difference between the sexes was found only in vitamin D and was lower in girls. The high risk of the patient and the presence of radiotherapy indication were found to be risky for the development of endocrine complications. iv Although the chemotherapeutics used today have prolonged survival, they have increased the frequency of complications. It is thought that these complications can be reduced by determining the risk factors in advance. Key Words: Pediatric ALL, endocrine complication, chemotherapy.