Nutritional Status Changes During Pediatric Acute Lymphoblastic Leukemia Treatment: A Study from a Tertiary Care Hospital in Pakistan.

BACKGROUND

Acute Lymphoblastic Leukemia (ALL) is the most common pediatric cancer with a 5-year survival rate of 90% in High Income Countries (HICs), but in lower-to-middle-income countries (LMICs) survival rates fall below 60%. This is influenced by many factors; one of the major ones being malnutrition.

OBJECTIVES

To ascertain the changes in and association of nutritional status in the treatment of pediatric ALL patients.

DESIGN

This article investigated the association between nutritional status in patients receiving ALL treatment, and morbidity and mortality. This is a retrospective study for the period of May 2022 to April 2023 including a total of 332 patients.

METHODS

The study used WHO defined weight-for-age and height-for-age for patients from 1 year of age up till the age of 5 years old, and BMI for age for patients over the age of 5 to assess nutritional status. Various disease and treatment variables were analyzed with patients' nutritional statuses.

RESULTS

From the sample, more than one-third of patients (38.5%) were malnourished with the majority of them being underweight or severely underweight. Wilcoxon signed-rank test for paired values showed a P-value of .0177 (z = 2.373) when used to compare patient weight at initial assessment and weight after intensive phase of treatment, indicating a significant change in weight between both timepoints. Nutritional status was significantly associated with the number of patients with positive bacterial cultures (P = .01) and multiple hospital admissions (P = .004), but was not significantly associated with mortality (P > .05).

CONCLUSION

Nutritional status changed significantly after intensive phase of treatment. Malnutrition in ALL patients was significantly associated with bacterial infections, however, it was not significantly correlated to patient mortality. Future prospective studies with a longer study period should be planned to follow patients compromised nutrition to assess long term survival.

REGISTRATION: Not applicable.