Nutritional parameters in children with malignancy

Nutritional status of 44 children with newly diagnosed malignancy was evaluated by anthropometric, hematological and biochemical parameters before initiating therapy and response to therapy was assessed during follow up. Malnutrition was seen in 56.8% children by weight for age criteria (WFA <-2 z). Low hemoglobin was found in 82% children, 25% had low total proteins (<5.7 g/dL), 20.5% low serum albumin (<3.2 g/dL), 27.3% low serum transferrin (<210 mg/dL) and 16.3% low serum iron (<60 ug/dL). Mean anthropometric and biochemical parameters were higher among the survivors compared to non-survivors. Significant difference between the well nourished and the malnourished group was detected in the achievement of remission/response (69.5% vs 38.1%), delays in therapy (8. 7% vs 38.1%) and mortality (30.5% vs 61.9%). Complications like febrile neutropenia and bleeding were more in the malnourished group. A statistically significant higher incidence of infection was seen in children with serum iron<60 ug/dL than those with higher values of serum iron (42.8% vs 8%). Malnutrition is a major determining factor in treatment planning, complication rates, response to therapy and survival.