Implications of undernutrition in children with acute lymphoblastic leukaemia during induction therapy – experience from a developing country
https://doi.org/10.31246/mjn-2020-0131
- Author:
Latha M Sneha
1
;
Lakshmanan SakthiKumar
2
;
Apurva Kadiyala
2
;
Julius Scott
1
;
Dhaarani Jayaraman
1
Author Information
1. 1Division of Pediatric Hemato Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai
2. Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
- Publication Type:Journal Article
- Keywords:
acute lymphoblastic leukaemia, induction therapy, outcome, undernutrition
- From:
Malaysian Journal of Nutrition
2022;28(No.1):79-86
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Undernutrition is an important prognostic factor in children with
acute lymphoblastic leukaemia (ALL) and higher incidences of mortality are reported
during induction remission in severely undernourished children. This study was
conducted to assess the prevalence and implications of malnutrition among ALL
children during induction therapy. Methods: All children ≤18 years diagnosed and
treated for ALL at our institution, between June 2010 to July 2016 were included
in this retrospective cohort study. Nutrition was assessed by body mass index-forage
z-scores calculated using World Health Organization’s Anthro (<5 years) and
Anthro-Plus Software (≥5 years). Children with a z-score of <-2 standard deviation
(SD) were classified as undernourished. All events and outcomes were compared
between undernourished and adequately nourished children. Results: A total of
72 children were included in this study. Nineteen (26.4%) were undernourished
at the time of diagnosis. Twenty-eight (38.8%) children had significant weight loss.
Sixty-seven of them attained remissions by the end of induction chemotherapy.
Five children who died had significant weight loss. Children with significant weight
loss during induction phase had a higher risk of developing complications such
as febrile neutropenia, pneumonia, mucositis, and drug interruptions. Those with
a deteriorating nutritional status had a higher chance of poor treatment outcome
(p=0.05, CI=95%). Conclusion: It is important to assess and monitor the nutrition
status of children and timely nutritional intervention is essential. A simple, cost
effective nutritional intervention that will decrease morbidity and mortality
associated with the disease must be devised.
- Full text:4.2022my0568.pdf
