Nutritional Parameters in Children with Acute Leukemia

Background: Nutritional problems with children suffering from cancer varies from extreme malnutrition to complex nutritional problems due to both disease and treatment.
Aim: In this study we intend to assess the nutritional status of the children with acute leukemia and the malnutrition effect on the evolution of the disease.
Material and method: We have performed a retrospective study on a group of 53 children suffering from acute leukemia who were diagnosed and treated in The Pediatric Clinic No. I Targu-Mures, The Department of Hematooncology within the period of 2001–2009. The nutritional status is assessed through anthropometric, hemathological and biochemical parameters before the initiation of chemotherapy.
Results: The group of study included 32 males and 21 females, with an average age of 7.2 years at the beginning of the malignant disease; out of 53 patients, 46 were diagnosed with acute lymphoblastic leukemia and 7 with acute myeloblastic leukemia.
At the beginning of the malignant disease, 10 patients (18.9%) had the weight under percentage 5 . The height corresponding to the age was, at the beginning of the disease under percentage 5 with 6 patients (11.32%), showing a chronic state of
malnutrition. The hemoglobin is diminished to 88.67% of the patients. Sideremia was lowered to 3.77% of the patients and increased to 45.28%. 35.85% of the children had the serum proteins decreased, from which 28.30% had hypoalbuminemia.
We had in view a period of 6 months since the initation of chemotherapy the response to the treatment by: realising the remission, an occurance of relapse, infectious episodes, those of febrile neuthropenia and the rate of death. In our study we have found that along with the children with a proper nutritional status, the malnourished children show a higher amount of infectious episodes (9.66 versus 7,32 infectious episodes/child); the number of the febrile neutropenia episodes was higher (3.8 versus 2.01 episodes/child). The remission at 6 months was slightly inferior in malnourished children, yet, the rate of mortality has not been influenced.
Conclusions: 1. The prevalence of the assessed severe malnutrition based on the anthropometric indicators was 18.9% at the beginning of the malignant disease. 2. The children’s smaller height at the beginning of the tumoral disease is given by the chronic protein-caloric malnutrition,existing before the disease. 3. Among the malnourished patients, the frequency of the infectious episodes is higher and the remission at 6 months is inferior to those with a normal nutritional status, however the rate of death is not different.