Malnutrition in paediatric patients with leukaemia and lymphoma: a retrospective cohort study

González, Hardenson Rodríguez; Mejía, Sergio Andrade; Ortiz, Javier Orlando Contreras; Gutiérrez, Adriana Patricia Osorno; López, Jorge Eliécer Botero; Quintana, Javier Enrique Fox

doi:10.3332/ecancer.2021.1327

Cited by 3 publications

(1 citation statement)

References 48 publications

(48 reference statements)

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“…Malnutrition in ALL patients has been associated with reduced survival, increased drug toxicity, and treatment-induced complications [ 24 ]. However, research results are conflicting, and a clear association between the patient’s nutritional status and ALL outcomes needs to be established [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Changes in Nutritional Status during Induction Phase and Their Association with Fever and Minimal Residual Disease in Paediatric Acute Lymphoblastic Leukaemia

Gustaitė,

Everatt,

Kairienė

et al. 2023

Medicina

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Background and objectives: Acute lymphoblastic leukaemia (ALL) is associated with a cytokine imbalance and oxidative stress, which can be aggravated by malnutrition. Malnutrition, defined by the World Health Organisation (WHO) as obesity or undernutrition, can affect treatment complications and outcomes. Therefore, we aimed to analyse the change in the body mass index (BMI) z-score during induction, as well as evaluate the impact of childhood malnutrition on fevers at an ALL presentation and early response to therapy. Methods: An observational cohort study of 50 consecutive children with ALL, diagnosed in 2019–2022, was performed. Patients were divided into age groups of 0–5, 6–11, and 12–17 years. BMI-for-age z-scores were used to define undernutrition and overnutrition according to WHO growth standards. Results: The number of patients with an abnormal BMI increased from 3 (6%) at diagnosis to 10 (20%) at the end of induction (from 2 (4%) to 6 (12%) in overweight/obese, and from 1 (2%) to 4 (8%) in underweight patients). At the end of induction, all overweight/obese patients were 0–5 years old. On the other hand, a statistically significant decrease in the mean BMI z-score among patients aged 12–17 was observed (p = 0.005). The mean BMI z-score differed statistically significantly among children aged 0–5 presenting with and without fever (p = 0.001). The minimal residual disease (MRD) level at the end of induction was not related to BMI at diagnosis. Conclusions: Despite the use of steroids, adolescents are prone to losing weight during an ALL induction, in contrast to preschool children, who tend to gain weight under the same treatment. BMI at diagnosis was related to a fever of ≥38 °C (at ALL presentation) in the 0–5 age group. The results emphasise the importance of careful nutritional status monitoring, with younger and older children as important target groups for weight gain and weight loss interventions, respectively.

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Section: Discussionmentioning

confidence: 99%

Changes in Nutritional Status during Induction Phase and Their Association with Fever and Minimal Residual Disease in Paediatric Acute Lymphoblastic Leukaemia

Gustaitė,

Everatt,

Kairienė

et al. 2023

Medicina

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Nutritional Status as a Risk Factor for Doxorubicin Cardiotoxicity in Mexican Children with Acute Lymphoblastic Leukemia

Gándara-Mireles,

Lares-Asseff,

Reyes Espinoza

et al. 2024

Nutrition and Cancer

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Nutritional Status at Diagnosis as Predictor of Survival from Childhood Cancer: A Review of the Literature

et al. 2022

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Few studies so far have examined the impact of nutritional status on the survival of children with cancer, with the majority of them focusing on hematological malignancies. We summarized published evidence reporting the association of nutritional status at diagnosis with overall survival (OS), event-free survival (EFS), relapse, and treatment-related toxicity (TRT) in children with cancer. Published studies on children with leukemia, lymphoma, and other solid tumors have shown that both under-nourished and over-nourished children at cancer diagnosis had worse OS and EFS. Particularly, the risk of death and relapse increased by 30–50% among children with leukemia with increased body mass index at diagnosis. Likewise, the risk of TRT was higher among malnourished children with osteosarcoma and Ewing sarcoma. Nutritional status seems to play a crucial role in clinical outcomes of children with cancer, thus providing a significant modifiable prognostic tool in childhood cancer management. Future studies with adequate power and longitudinal design are needed to further evaluate the association of nutritional status with childhood cancer outcomes using a more standardized definition to measure nutritional status in this population. The use of new technologies is expected to shed further light on this understudied area and give room to person-targeted intervention strategies.

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Malnutrition in paediatric patients with leukaemia and lymphoma: a retrospective cohort study

Cited by 3 publications

References 48 publications

Changes in Nutritional Status during Induction Phase and Their Association with Fever and Minimal Residual Disease in Paediatric Acute Lymphoblastic Leukaemia

Changes in Nutritional Status during Induction Phase and Their Association with Fever and Minimal Residual Disease in Paediatric Acute Lymphoblastic Leukaemia

Nutritional Status as a Risk Factor for Doxorubicin Cardiotoxicity in Mexican Children with Acute Lymphoblastic Leukemia

Nutritional Status at Diagnosis as Predictor of Survival from Childhood Cancer: A Review of the Literature

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