Research findings from Mayo Clinic investigators demonstrate that diabetes did not increase the risk of death among patients with acute or chronic myeloid leukemia.
Research findings from Mayo Clinic investigators in Arizona demonstrate that diabetes did not increase the risk of death among patients with acute (AML) or chronic myeloid leukemia (CML), according to the study published in Future Science OA.
Nor did leukemia status have an impact on glycemic control for these patients, in this retrospective study that saw patients with (n = 70) and without diabetes (n = 70; the control cohort), matched 1:1, who were seen between January 1, 2007, and December 31, 2015. Electronic health records were reviewed for overlaps of cancer diagnoses and diabetes claims.
The primary outcome was overall survival (OS), defined as “time from leukemia diagnosis until death of any cause,” with a secondary outcome of glucose level at 1 year after leukemia diagnosis. Median patient age was 62 (range, 19-94), most were men (60%) and non-Hispanic (60%) or White (83.6%), and 88.6% had AML.
“Studies have shown an increased risk of death of certain solid cancers in patients with diabetes, but data are limited and inconsistent regarding the association between leukemia, diabetes, and death,” the authors noted. “The goal of this study was to evaluate the association between diabetes and survival among patients with acute and chronic myeloid leukemia and the association between leukemia and glycemic control.”
Results show that close to 36% (n = 25) of patients in the diabetes cohort had a mean (SD) hemoglobin A1C of 6.8% (1.3%) with 1 year of follow-up of diagnosis—which did not change. Mean glucose values did significantly differ, though, between the groups (P < .001).
Three-year OS rates were almost equal, however, in the diabetes and control cohorts, at 46% (95% CI, 35%-61%) and 45% (95% CI, 33%-61%; P = .79), respectively. This was despite graft-versus-host disease occurring at similar rates in both cohorts (P < .001), close to 80% of all patients undergoing chemotherapy, and 16% of the control cohort and 21% of the diabetes cohort receiving targeted therapy.
A prominent factor related to potential cancer development from the presence of diabetes is the disturbance of glucose metabolism, which can lead to the increased uptake of glucose by cancer cells, which itself provides a mechanism of growth for those malignant cells.
Analyses further revealed the following:
The authors highlight 2 possible reasons for their positive findings:
“There are limited studies addressing long-term outcomes in patients with leukemia and diabetes; confirmation of these observations in larger patient cohorts is needed,” the authors concluded. “Investigation of the effect of intensive insulin therapy on leukemia survival rate is of interest and worthy of future study.”
Also, because most of the patients in the diabetes cohort lacked data on hemoglobin A1C levels, further study and quality-improvement initiatives are needed in this area.
Reference
Wiedmeier J, Mountjoy LJ, Buras MR, et al. Mortality and glycemic control among patients with acute and chronic myeloid leukemia and diabetes: a case-control study. Future Sci OA. Published online October 26, 2020. doi:10.2411/fsoa-2020-0177
BrECADD Regimen Reaches “Unprecedently High” PFS for Patients With Hodgkin Lymphoma
June 18th 2024The treatment regimen not only significantly improved progression-free survival (PFS) for patients with advanced stage classic Hodgkin lymphoma but was also better tolerated compared with a 20-year-old regimen being used.
Read More
Lymphoma Research Foundation CEO on Biden’s Cancer Moonshot, Financial Toxicity
February 3rd 2022On this episode of Managed Care Cast, we speak with Meghan Gutierrez, CEO of the Lymphoma Research Foundation, about financial toxicity, how the pandemic has affected patients’ financial needs when they have cancer, health care disparities and care gaps, and more.
Listen
alloHSCT Yields Benefits in R/R AML Regardless of Leukemia Burden
December 22nd 2023Those with chronic graft-versus-host-disease who have received allogeneic hematopoietic stem cell transplant (alloHSCT) may experience enhanced graft-versus-leukemia effects, thus producing a lower relapse rate in acute myeloid leukemia.
Read More
Keeping Patients With Cancer Out of the ED Through Dedicated Urgent Care
October 13th 2021On this episode of Managed Care Cast, we bring you an interview conducted by the editorial director of OncLive® who talks with the advance practice provider chief at Winship Cancer Institute about how having a dedicated cancer urgent care center will make cancer treatment plans seamless whil helping patients avoid exposure to infectious diseases in emergency department waiting rooms.
Listen
Zanubrutinib May Be Viable Option After Acalabrutinib Intolerance in B-Cell Malignancies
December 11th 2023Patients with B-cell malignancies who were intolerant to treatment with acalabrutinib experienced clinically meaningful benefits when treated with zanubrutinib, suggesting zanubrutinib may be a viable treatment option for this population.
Read More