Nutritional status at the moment of diagnosis in childhood cancer patients

Połubok, Joanna; Malczewska, Anna; Rąpała, Małgorzata; Szymocha, Jerzy; Kozicka, Marta; Dubieńska, Katarzyna; Duczek, Monika; Kazanowska, Bernarda; Barg, Ewa

doi:10.18544/pedm-23.02.0077

Cited by 6 publications

(6 citation statements)

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“…This is evident in studies like that of Maia Lemos et al [31] in Brazil, where undernourishment was found at diagnosis in up to 27.3% of patients, that of Villanueva et al [32] in Guatemala that reported 47% or that of Peccatori et al [33] in Nicaragua that reported 65.4%. The latter coincides with the undernourishment percentages reported in low and low to middle-income countries, where it reaches up to 40%-90% [34,35]. It is thereby important to emphasise that in the definition of malnutrition heterogeneity is a determinant of the variability reported in different studies, the methodology used to assess the nutritional status (anthropometric or biochemical measures) and the criteria or cut-off points that vary from population to population, thus making it difficult to accurately estimate the prevalence of cancer-related malnutrition [36].…”

Section: Discussionsupporting

confidence: 86%

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

González¹,

Mejía²,

Ortiz³

et al. 2021

ecancer

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Introduction: Paediatric cancer is a potentially curable disease and its prognosis has been linked to several factors, such as nutritional status. The impact of malnutrition on these patients, either by overnutrition or undernutrition, varies and its relationship with outcomes is inconsistent. This study was conducted in order to determine the frequency of malnutrition in children with haematolymphoid malignancies at the time of diagnosis, as well as during treatment and to also investigate its relationship with the development of infections and death. Materials and Methods:A retrospective cohort study of 191 children with a recent diagnosis of a haematolymphoid malignancy. The risks and nutritional classification were determined using anthropometry, follow-ups were conducted for up to 24 months and the presentation and frequency of infections and/or death were also recorded. Bivariate and multivariate analyses were conducted using binomial logistic regressions, for death and infection outcomes during follow-up. Survival analysis was conducted for various factors and types of cancer.Results: 83.7% of children had a sufficient nutritional classification at diagnosis, 6.8% had malnutrition by undernutrition and 9.4% by overnutrition. 83.8% had at least one infectious complication during follow-up and 47.1% had ≥ 3. This percentage increased to 69.2% when configuring it in the malnutrition by undernutrition group. 18.3% of patients died. When configuring the mortality, the percentage was greater in patients with Acute Myeloid Leukaemia (AML) (57.1%) and malnutrition by undernutrition (30.7%). The multivariate analysis for the outcome of death, only showed a statistically significant variable (AML odds ratio = 26.52; confidence interval = 1.09-643.24; p = 0.04). Conclusion:No statistically significant relationship was found between the nutritional status of children with haematolymphoid neoplasms, and outcomes such as infections or Research

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Section: Discussionsupporting

confidence: 86%

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

González¹,

Mejía²,

Ortiz³

et al. 2021

ecancer

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“…Similar results were obtained by Gurney et al and Pietila et al in clinical survivors of brain tumors who consider radiation therapy as the most important risk factor for obesity [17,18]. Our previous studies have shown that children with soft tissue tumors at the time of diagnosis are more prone to developing overweight and obesity compared to other types of childhood cancers [19]. There are several theories explaining the causes of such complications.…”

Section: Obesity/overweightsupporting

confidence: 86%

Metabolic Disturbances in Children Treated for Solid Tumors

et al. 2019

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Metabolic disturbances are among the most common disorders diagnosed in pediatric patients after anti-cancer therapy (ACT). The aim of our study was to evaluate the prevalence of metabolic disturbances among patients after ACT. The study group comprised 44 patients (31 boys) treated for solid tumors and 31 patients in the control group. Body weight, height, body mass index (BMI) values, lipid parameters are expressed in Standard Deviation Score (SDS), based on centile charts. Indicators of risk to atherosclerosis were calculated. Obesity/overweight was observed in one third of the patients. Hypercholesterolemia occurred in half of them, elevated tryglicerides (TG) SDS in 11, and elevated low-density lipoprotein cholesterol (LDL-C) SDS in nine of the patients. Increased levels of both cholesterol SDS and LDL SDS were found in nine patients and four of them also showed elevated levels of TG SDS. There were significant differences in lipid parameters between the sexes. Risk indicators of lipid disorders defined by statistical distances (τ) were determined for the study group and the control group. The sum of the risk ratios of lipid disorders in the study group was 150 times higher than in the control group. Patients after ACT require special monitoring of lipids profiles and thyroid function as they are at higher risk for dyslipidemia and atherosclerosis than healthy people.

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“…To our knowledge, this is the first prospective cohort study of the nutritional status of children with solid tumors in Brazil and the correlation with the outcomes. Few studies have addressed the nutritional assessment of pediatric patients with solid tumors 4,22,24,27 . In the present study, combination of the anthropometric indices, BMI/A z ‐score and MUAC percentile, to assess nutritional status highlighted the limitations of using BMI alone, especially in children with solid tumors who were undergoing treatment in an LMIC where large tumor masses are often present, which further limits the usefulness of the BMI/A for accurately assessing nutritional status.…”

Section: Discussionmentioning

confidence: 92%

Malnutrition at diagnosis and throughout therapy in pediatric patients with solid tumors: A single‐institution study in a developing country

Sasse

Bergmann

Afonso

et al. 2021

Pediatric Blood & Cancer

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Background Changesin nutritional status can constitute a risk factor for reduced tolerance and effectiveness of antineoplastic treatment. Knowledge of the nutritional status of pediatric patients is important for implementing interventions to improve outcomes. We aimed to evaluate nutritional status at diagnosis and throughout therapy in pediatric patients with solid tumors. Objectives To study the prevalence of malnutrition at diagnosis, compare different assessment tools, and examine longitudinal changes in nutritional status during the treatment of pediatric patients with solid tumors in a Brazilian institution. Methods This prospective single‐center study enrolled patients with solid tumors (age <19 years) from June 2017 to May 2018. Nutritional evaluations were performed at diagnosis and after 3 and 6 months of treatment. z‐Scores for height for age (H/A) and body mass index for age (BMI/A) were calculated using the Anthro/AnthroPlus software and mid‐upper arm circumference (MUAC) percentile was used for nutritional classification. Results The prevalence of nutritional status at diagnosis was 29.3% malnourished, 49.5% adequate, and 21.2% overweight/obese. Nutritional status improved during the first 3 months of treatment, with a reduction in the proportion of malnourished patients and an increased number of patients with adequate nutritional status. Conclusions The two combined indices, BMI/A and MUAC, facilitated the diagnosis of a greater number of patients with solid tumors who had nutritional alterations. A high prevalence of malnutrition was present at diagnosis. Nutritional status improved in the first 3 months of treatment and could be related to the multidisciplinary institutional approach following the diagnosis.

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Nutritional status at the moment of diagnosis in childhood cancer patients

Abstract: ALL patients are less susceptible to underweight than the patients with the solid tumor. Moreover, the high incidence of overweight in children with ALL is noteworthy.

Cited by 6 publications

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

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

Metabolic Disturbances in Children Treated for Solid Tumors

Malnutrition at diagnosis and throughout therapy in pediatric patients with solid tumors: A single‐institution study in a developing country

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