1019-P: Continuous Glucose Monitoring in Pediatric Acute Lymphoblastic Leukemia

Introduction & Objective: Children with acute lymphoblastic leukemia/lymphoma (ALL/LLy) may experience significant treatment-related toxicities, graded per National Cancer Institute-prescribed definitions. During induction, development of hyperglycemia can cause significant morbidity, including monitoring, medical management, or prolonged hospitalization. An objective of the pilot study is to evaluate feasibility and efficacy of continuous glucose monitoring system (CGM) in pediatric ALL/LLy patients.

Methods: A prospective study of patients with ALL/LLy aged 1-21 years began on 2/11/2022 and is ongoing at Children’s Healthcare of Atlanta. After consent to a parent study measuring markers of hyperglycemia risk, patients are invited to enroll in a blinded CGM arm. Libre pro was utilized. Demographic and clinical data (family history of diabetes, medications, targeted AEs presence and grade) are obtained via manual chart abstraction. Descriptive statistics were calculated for study variables.

Results: As of December 2023, 53 patients completed induction in the parent study: 30 (57%) male, 35 (66%) White, 13 (35%) Black, and 42 (79%) Non-Hispanic/Latino. Diagnosis age median was 5.1 years (1.3-18.6). All patients experienced hyperglycemia: 41 (77%) grade 1; 12 (23%) grade 2+ (grade 2: n=7, 13%; grade 3: n=5, 9%). Grade 2+ hyperglycemia patients were more like to have a family history of diabetes (7/12, 53% vs. 8/41, 20%, p=0.03). Insulin management was required in grade 3 hyperglycemia. CGM was consented to and worn by 9 patients (17%) with an average CGM active time of 77% (88-92%) and 6 patients had >70% wear time. During induction, 4 (44%) of the CGM arm required, compared to 1 (2%) of the non-CGM arm. CGM utilizers had no skin rash or infection at CGM site.

Conclusion: A pilot study of children with ALL/LLy showed blinded CGM technology worn during induction therapy has reliable results without complications. Additional studies are needed to explore expanded use of CGM in similar patient populations.