Nutritional Assessment of Children with Acute Lymphoblastic Leukemia

Kadir, Rula Ahmed Abdul; Hassan, Janan G.; Aldorky, Mohammed K

doi:10.21767/2254-6081.1000128

Cited by 3 publications

(3 citation statements)

References 10 publications

(21 reference statements)

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“…Several other ALL studies also reported higher prevalences in males than females. 7,13,14 The mean age was 7.5 years in the well-nourished group and 6.9 years in the malnourished group. A study in Semarang reported a median age of 6.58 years in childhood ALL.…”

Section: Discussionmentioning

confidence: 99%

“…6 Nutritional supportive care is a medical modality associated with improved tolerance to chemotherapy, increased survival rate and quality of life, as well as decreased risk of infection in children undergoing anticancer therapy. 7 Induction is an important chemotherapy phase, in which maximum destruction of leukemic cells occurs. 8 Therefore, nutritional status evaluation at the initial diagnosis and its possible association with induction phase outcome is needed.…”

mentioning

confidence: 99%

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Differences in induction phase outcomes of acute lymphoblastic leukemia between well-nourished and malnourished pediatric patients

Simarmata¹,

Rosdiana

Wahyuni

2023

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Background Leukemia is the most common malignancy in childhood. Malnutrition is the main nutritional disorder occurring in children with cancer. Nutritional supportive care is a medical modality that has been associated with improved tolerance to chemotherapy, survival, and quality of life, as well as decreased risk of infection in children undergoing cancer therapy. Objective To examine differences in induction phase outcomes in well-nourished and malnourished pediatric acute lymphoblastic leukemia (ALL) patients. Methods This prospective study was conducted in newly-diagnosed ALL patients aged 1 to 18 years who underwent induction phase chemotherapy at Haji Adam Malik General Hospital, Medan, North Sumatera. Mid-upper arm circumference (MUAC) was used to determine nutritional status. Patient characteristics such as complete blood count (CBC) at the time of diagnosis, occurrence of febrile neutropenia, duration of induction, length of hospital stay, and remission status were collected. We analyzed differences in CBC, frequency of febrile neutropenia, as well as duration of induction and hospital stay between well-nourished and malnourished patients. We also assessed the difference in remission attainment between the two groups. Results There were 21 subjects in each group. Compared to well-nourished subjects, malnourished ones had a higher median incidence of febrile neutropenia [1 (range 0 to 30) vs. 3 (range 0 to 4); P=0.04], longer mean induction duration [64.2 (SD 11.5) vs. 71.2 (SD 10.6) days; P=0.046], and longer median hospital stay [30 (range 19 to 56) vs. 36 (range 22 to 49) days; P=0.001] compared to well-nourished subjects. There was no significant difference in CBC parameters and remission status after induction between the two groups. Conclusion Malnourished pediatric ALL patients had a significantly higher incidence of febrile neutropenia, duration of induction phase, and duration of hospital stay compared to well-nourished ALL patients.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Differences in induction phase outcomes of acute lymphoblastic leukemia between well-nourished and malnourished pediatric patients

Simarmata¹,

Rosdiana

Wahyuni

2023

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“…al. [16] which showed that most patients with acute leukemia had excess fat reserves during chemotherapy, which is a result of corticosteroid therapy that causes alteration in fat metabolism, which had a net effect of increasing body fat and redistribution of body fat causing truncal obesity [19]. *One of the limitations of this study DXA was not used for the assessment of body composition, not available in this center.…”

Section: Mid-upper Arm Fat Area For Age In Percentile (During Chemoth...mentioning

confidence: 95%

Assessment of the Nutritional Status of the Children with Acute Leukemia on Chemotherapy in Karbala City

Dheyaa Aldeen Nawfal Al-khateeb,

Ali Hussein Al-hafidh,

Usama Ahmed Hadi Al-jumaily

2022

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Acute leukemia is the most cancer has frequency in children, Malnutrition is one of the common complications of children with cancer, and malnutrition has been identified as a significant factor in treatment tolerance, increased morbidity, poor prognosis, reduced quality of life, and higher healthcare expenses. The study objective was to assess the nutritional status of children with acute leukemia during chemotherapy and find any association between malnutrition and the others factor. The study Methods were a case-control study conducted in Karbala city/Iraq, for 3 months, the study sample included 140 children (70 cases and 70 controls) aged (2 to 14) years, by using convenient sampling and use special questionnaire design and measuring anthropometric measures. The results revealed that the highest percentage of patients in the age group 5-10 years (47.1%), the boys were (55.7%), (52.9%) of patients live in urban, highly significant association (p.value < 0.001) of family history of cancer, has less physical activity and psychological effects on loss of appetite. Nutritional assessment during chemotherapy (48.6%) of case groups was normal weight, The results of this study indicate that the participants who had normal weight were at likely lower risk of complication acute leukemia than those with acute malnutrition (P. value=0.022; OR=0.297). According to the mid-upper arm composition assessment, the results show the highest percentage (35.7%, 34.3%) of patients were wasted and below average muscle area, and the highest percentage (51.4%, and 88.6%) of case and control groups were normal fat respectively. Effect of dietary habits can be summarized as the children treated with chemotherapy are consuming diets of medium quality, with little quantity Conclusion: the children with acute leukemia had a high association of malnutrition with low socioeconomic status, poor dietary habits, low physical activity, psychological effects, and duration and type of cancer therapy.

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Characteristics, Treatment Complexity, and Outcome of Mixed-Phenotype Acute Leukemia in Children in a Low–Middle-Income Country

et al. 2022

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BackgroundMixed-phenotype acute leukemia (MPAL) in children is an uncommon subtype of acute leukemia that cannot be definitively assigned to a specific lineage. There is no consensus on the best approach to therapy. Management is more complex in low–middle-income countries (LMICs).AimTo evaluate the clinicopathological characteristics and outcomes of patients with MPAL in a developing country.Patients and MethodsA retrospective descriptive study of 42 pediatric patients newly diagnosed with MPAL from July 2007 until December 2017.ResultsThe immunophenotyping was T/Myeloid in 24 patients (57.1%) and B/Myeloid in 16 (38.1%). Three subjects had MLL gene rearrangement, two had Philadelphia-positive chromosomes, and eight had FMS-like tyrosine kinase 3 (FLT3-ITD) internal tandem duplication (FLT3-ITD) with a ratio >0.4. Two subjects died before starting chemotherapy. Ten patients (25%) received acute lymphoblastic leukemia (ALL) induction, and all achieved complete remission (CR) with no induction deaths and no shift of therapy. Thirty patients (75%) started therapy with acute myeloid leukemia (AML) induction: five (16.6%) died during induction, 17 (56.7%) achieved CR, and 10 patients received maintenance ALL therapy after ending AML treatment. Four of the eight patients with induction failure were switched to ALL therapy. The 5-year event-free survival (EFS) and overall survival (OS) rates were 56.7% [standard error (SE): 8.1%] and 61% (SE: 8%), while the cumulative incidence of relapse was 21.7% (SE: 6.7%), with a median follow-up duration of 5.8 years. Patients treated with ALL-directed therapy had a 5-year EFS rate of 111 70% (SE: 14%) and OS rate of 78.8% (SE: 13%). Patients treated with ALL-directed therapy had a 5-year EFS rate of 70% (SE: 14.5%) and OS rate of 78.8% (SE: 13%). FLT3-ITD mutation showed a significantly lower 5-year EFS rate of 28.6% (SE: 17%) vs. 75% (SE: 9%) for the wild type, p = 0.032. Undernourished patients with a body mass index (BMI) z-score ≤-2 at presentation had a significantly lower 5-year EFS rate of 20% (SE: 17%) compared to 61.8% (SE: 8%) for patients with BMI z-score >-2, p = 0.015.ConclusionThis study supports ALL-directed therapy for pediatric MPAL in a setting of LMIC. Given the poor outcome of FLT3-ITD, the role of FLT3 inhibitor needs to be explored in this subset of cases.

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Nutritional Assessment of Children with Acute Lymphoblastic Leukemia

Cited by 3 publications

References 10 publications

Differences in induction phase outcomes of acute lymphoblastic leukemia between well-nourished and malnourished pediatric patients

Differences in induction phase outcomes of acute lymphoblastic leukemia between well-nourished and malnourished pediatric patients

Assessment of the Nutritional Status of the Children with Acute Leukemia on Chemotherapy in Karbala City

Characteristics, Treatment Complexity, and Outcome of Mixed-Phenotype Acute Leukemia in Children in a Low–Middle-Income Country

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