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.
Tag Archives: malnutrition
Issues on Malnutrition in Children with Cancer
Introduction: Malnutrition is present in a high percentage in children with cancer. It can be evaluated by anthropometric measurements and laboratory data.
Aims: 1. To determine the prevalence and severity of malnutrition at diagnosis in children with cancer. 2. To define the best modalities to assess nutritional status.
Material and methods: A prospective study was performed on 27 children hospitalized and diagnosed with various type of cancer in the Pediatric Clinic No.I Targu-Mures, between November 2009–January 2011. We evaluated anthropometric and biochemical parameters: weight, height, body mass index (BMI), middle-upper arm circumference (MUAC), triceps skin fold thickness (TSF), total protein, albumin, Insulin-like growth factor-1 (IGF-1). We divided patients into three categories depending on nutritional parameters: severely malnourished, risk of malnourished and adequately nourished. We correlated anthropometric parameters with biochemical parameters.
Results: Our group consisted of 20 males (74.04%) and 7 females (25.96%). Of the 27 children with cancer, 14 children were severely malnourished, 8 children were with risk of malnourished and only 5 children with normal nutritional status. At the onset of malignant disease, 16 patients (59.25%) had low serum protein values and 10 patients (37.03%) had low levels of serum albumin. IGF-1 was decreased in 18 children (66.66%). We found a good correlation, statistically significant between TSF and serum proteins (r = 0.41; p = 0.02), between TSF and IGF-1 (r = 0.44; p = 0.02), and between MUAC and IGF-1 (r = 0.39; p = 0.04).
Conclusions: 1. The prevalence of malnutrition in children with cancer is high. 2. Arm anthropometry in conjunction with serum protein and IGF-1 most accurately characterizing the nutritional status.