A Study of the Nutritional Status of Pediatric Cancer Patients

Donaldson, Sarah S.; Wesley, Margaret N.; DeWys, William D.; Suskind, Robert M.; Jaffe, Norman; vanEys, Jan

doi:10.1001/archpedi.1981.02130360015007

Cited by 83 publications

(110 citation statements)

References 3 publications

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“…Higher infection rate was also reported in malnourished children with metastatic bone disease compared to well-nourished ones (van Eys et al 1980). Furthermore, an association was found between the degree of malnutrition and the relapse rate in children with solid tumours (Donaldson et al, 1981). The same study reported decreased survival in children with malignancies whose weight for height ratio was 80% of median for age compared to well-nourished ones.…”

Section: Nutritional Status As a Determinant Of Outcomementioning

confidence: 81%

“…Some researchers claim that children with cancer have a high incidence of wasting and stunting were 18% and 31% respectively even at the time of diagnosis (Tickard et al, 1983a, b;Berry et al, 1983;Kibirige et al, 1988;Rickard et al, 1989a, b). Others do not support the above ®nding (Donaldson et al, 1981;Carter et al, 1983b;Besscho 1986;Tamminga et al, 1990), while others report a high incidence of malnutrition (Aker et al, 1983;Berry et al, 1983). Aker et al, reported that 16% of patients admitted for BMT due to acute myelogenous leukaemia had a weight less than 90% of ideal body weight (IBW), 17% had an arm muscle area (AMA) less than the 10th centile and 12% had arm fat area (AFA) less than 10th centile.…”

Section: Indications For Bone Marrow Transplantation As Determinants mentioning

confidence: 97%

“…Some researchers claim that children with cancer have a high incidence of wasting and stunting (Rickard et al, 1983a,b;Kibirige et al, 1988;Rickard et al 1989a;(Berry et al, 1983), even at the time of diagnosis, compared to a healthy population. Others do not support the above ®nding (Donaldson et al, 1981;Carter et al, 1983b;Besscho 1986;Tamminga et al, 1990). Most clinicians, however, agree that intensive chemotherapy is often associated with a deterioration of nutritional status of the patients (Bernstein & Sigmundi, 1980;Dorr & Fritz 1980;Rickard et al, 1980;Bernstein et al, 1982;Donaldson et al, 1981;Nunnaly, 1983;Keenan 1989;Kennedy & Diamond, 1997;Papadopoulou et al, 1996a).…”

Section: Indications For Bone Marrow Transplantation As Determinants mentioning

confidence: 99%

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Nutritional considerations in children undergoing bone marrow transplantation

Papadopoulou

1998

Eur J Clin Nutr

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Bone marrow transplantation is often associated with multiple organ failure which is usually reversible. Oral mucositis and dysphagia, vomiting, diarrhoea, protein losing enteropathy, transient exocrine pancreatic impairment, hypoalbuminaemia, biochemical trace element and mineral de®ciencies are all common following transplantation and have profound nutritional consequences. Malnutrition affects negatively the clinical outcome. Nutritional support is provided to malnourished patients and those who suffer deterioration in nutritional status despite the provision of dietetic counselling. Only a few randomised studies comparing enteral with parenteral nutrition after transplant exist. Both enteral tube feeding (in the absence of mucositis) and parenteral nutrition are effective in maintaining nutritional status. However, enteral nutrition is associated with a better nutritional response and fewer complications than parenteral. With existing enteral and parenteral nutrition regimens close monitoring of trace element and mineral status is required.

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Section: Nutritional Status As a Determinant Of Outcomementioning

confidence: 81%

Section: Indications For Bone Marrow Transplantation As Determinants mentioning

confidence: 97%

Section: Indications For Bone Marrow Transplantation As Determinants mentioning

confidence: 99%

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Nutritional considerations in children undergoing bone marrow transplantation

Papadopoulou

1998

Eur J Clin Nutr

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“…Malignant diseases and their treatment are commonly associated with protein-energy malnutrition (Donaldson et al, 1981;Rickard et al, 1983;Donaldson, 1982). At diagnosis of pediatric solid tumors, the incidence of malnutrition ranges up to 50% (Rickard et al, 1983).…”

Section: Introductionmentioning

confidence: 99%

“…At diagnosis of pediatric solid tumors, the incidence of malnutrition ranges up to 50% (Rickard et al, 1983). Especially at the beginning of treatment, protein energy reserves are of clinical importance for the outcome: in children with solid tumors, poor nutritional status at presentation is associated with increased relapse rates (Donaldson et al, 1981). In adult cancer patients, PEM has also been a frequent ®nding and a poor prognostic sign (Nixon et al, 1980).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of muscle protein mass in children with solid tumors by muscle thickness measurement with ultrasonography, as compared with anthropometric methods and visceral protein concentrations

Taskinen

Saarinen-Pihkala

1998

Eur J Clin Nutr

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Objective: To compare the merits of regional ultrasonography, anthropometry, and measurement of visceral protein concentrations for determining muscle protein mass and nutritional status. Design: Prospective follow-up study. Subjects: Nineteen children (median age 4.7 y, range, 1.4 ±14.1 y) with malignant solid tumors were examined at diagnosis, monthly during preoperative chemotherapy, and 1±2 months after operation; 19 healthy age-and sex-matched children served as controls. Interventions: We measured the thickness of the quadriceps muscle by ultrasonography (muscle index), and body weight, mid-arm circumference, triceps skinfold thickness, and serum concentrations of albumin, prealbumin, and transferrin. Results: At diagnosis, the muscle index was smaller in the patients (mean 5.6 cm 2 am 2 , 95% CI 4.5 ± 6.7 cm 2 am 2 ) than in the controls (8.5 cm 2 am 2 , 95% CI 7.7±9.3 cm 2 am 2 ) (P 0.0007), whereas the anthropometric measurements did not differ. The sensitivity, speci®city, and predictive value of anthropometry and measurements of visceral proteins were poor in detecting reduced muscle protein reserves when compared with the muscle index as the baseline standard. During the anticancer therapy the mean concentrations of serum albumin and prealbumin increased. Conclusions: In children with cancer, nutritional status should be assessed with methods more sensitive than anthropometry and visceral protein concentration measurements. We advocate regional ultrasonography for the evaluation of nutrition in these patients. Sponsorship: This work was supported by the Foundation for Pediatric Research, Helsinki, Finland.

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Mortality in Overweight and Underweight Children With Acute Myeloid Leukemia

Lange¹

2005

JAMA

262

212

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to 600 individuals younger than 21 years develop acute myeloid leukemia (AML). 1 Current treatment for AML typically consists of 3 or 4 courses of intensive, myelosuppressive chemotherapy with or without bone marrow transplantation from a histocompatible family donor. This therapy cures about half the children with AML; of the other half, most succumb to AML-related causes, but 5% to 15% die from toxic effects of treatment. 2-4 Factors that predict treatment failure and death in AML are relatively older age and higher white blood cell (WBC) count at diagnosis, a slow response to the first course of chemotherapy, 3-6 and, in the United States, black race and absence of a histocompatible family member to donate marrow for transplantation. 7,8 Children's Cancer Group (CCG)-2961 was a phase 3 international cooperative group trial for pediatric patients with untreated AML. It was the impression of investigators (J.F., B.J.L.) on this trial that overweight children and adolescents experienced more toxicity and death than did the other patients. This observation prompted the following retrospective investigation of effects of body mass index (BMI) on survival and treatment-related mortality. METHODS CCG-2961 opened on August 30, 1996, and closed on December 4, 2002. Patients from birth through age 20 years were enrolled after institutional review board approval of each participating institution and written informed consent. Patients with Down syndrome, Fanconi anemia, acute promyelocytic leukemia, acute undifferentiated leukemia, or treatment-related AML were excluded from the study. The trial accrued 902 patients with de novo AML. Thirty patients without outcome data and 104 infants younger than 1 year were excluded from this analysis, leaving 768 patients. AML was classified according to French-American-British criteria. 9 Morphology, histochemistry, and karyo

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A Study of the Nutritional Status of Pediatric Cancer Patients

Cited by 83 publications

References 3 publications

Nutritional considerations in children undergoing bone marrow transplantation

Nutritional considerations in children undergoing bone marrow transplantation

Evaluation of muscle protein mass in children with solid tumors by muscle thickness measurement with ultrasonography, as compared with anthropometric methods and visceral protein concentrations

Mortality in Overweight and Underweight Children With Acute Myeloid Leukemia

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