Implications of undernutrition in children with acute lymphoblastic leukaemia during induction therapy – experience from a developing country

Sneha, Latha M and SakthiKumar, Lakshmanan and Kadiyala, Apurva and Scott, Julius and Jayaraman, Dhaarani (2022) Implications of undernutrition in children with acute lymphoblastic leukaemia during induction therapy – experience from a developing country. Malaysian Journal of Nutrition (Malaysia), 28 (1). pp. 79-86. ISSN 1394 – 035X

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 available from: Official URL: https://www.nutriweb.org.my/mjn/publication/28-1/V...

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.

[error in script]

Item Type:	Article
AGROVOC Term:	leukaemia
AGROVOC Term:	children
AGROVOC Term:	undernutrition
AGROVOC Term:	malnutrition
AGROVOC Term:	nutrition assessment
AGROVOC Term:	statistical methods
AGROVOC Term:	nutritional status
AGROVOC Term:	risk factors
AGROVOC Term:	nutrition policies
Geographical Term:	India
Uncontrolled Keywords:	acute lymphoblastic leukaemia, induction therapy, outcome, undernutrition
Depositing User:	Ms. Azariah Hashim
Date Deposited:	28 Feb 2025 03:00
Last Modified:	28 Feb 2025 03:00
URI:	http://webagris.upm.edu.my/id/eprint/1945

Actions (login required)

View Item