Nutritional Assessment of Children with Acute Lymphoblastic Leukemia

Abstract

Background: The high prevalence of malnutrition in adult and pediatric cancer patients has been appreciated for decades and continues to be documented. Although the prognostic significance of nutritional status among patients with cancer remains controversial, it is generally accepted that the nutritional support is an important aspect of medical therapy. Objective: Assess the nutritional status of children with acute lymphoblastic leukemia at time of diagnosis of disease, assess the nutritional status of the same children during induction of chemotherapy and after induction by 3-6 weeks. Patients and methods: A prospective study was carried out on thirty children their age ranged from (1-14 year) with newly diagnosed acute lymphoblastic leukemia, (16) of them were males and (14) were females, who were admitted to the oncology pediatric Unit in Basrah Maternity and children Hospital, from the first of January to the end of October -2010). This study has been done to determine the nutritional status of children with newly diagnosed acute lymphoblastic leukemia before, during and after induction by (3-6 weeks). Full history was taken from each patient regarding chief compliant, dietary history, also clinical examination and anthropometric measurement by measure weight, height, mid upper arm circumference and body mass index, in addition investigation in form of Hb, serum albumin, serum cholesterol, and random blood sugar. Results: This study has revealed that among 30 patients with newly diagnosed ALL, 15 (50%) of them are underweight according to weight for age, 8 of them are male and 7 are females. Twelve (40%) of these 30 patients are wasted, 7 of them are male and 5 are female. Fourteen (46.7%) of the total 30 patients are malnourished according to body mass index, 6 of them are male and 8 are female, ten (33.3%) are malnourished according to mid upper arm circumference, five of them are male and 5 are female. The study has revealed that there is a statistically significant increase in mean body weight during induction with P value (0.046) and a statistically increase in body mass index during induction with P value (0.005). During induction, there is decrease in serum calcium with P value (0.001), and a significant decrease in serum albumin with P value (0.005), also in this study there is a significant decrease in serum cholesterol during induction with P value (0.001). There is no significant increase in random blood sugar during induction. Conclusion: Malnutrition exists in a significant proportion of children with acute lymphoblastic leukemia. So, adequate nutrition is an important in such children, to ensure optimal treatment and outcome.