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Nutritional parameters in children with cancer
S Shah1, M A Rahman, M A Mannan
1Department of Haematology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh.
Insights
Malnutrition significantly impacts pediatric cancer patients, leading to poorer treatment response, increased therapy delays, and higher mortality rates. Early nutritional assessment is crucial for improving outcomes in childhood cancer.
Area of Science:
- Pediatric Oncology
- Clinical Nutrition
- Hematology
Background:
- Childhood malignancy presents significant challenges, with nutritional status often overlooked.
- Malnutrition is prevalent in pediatric cancer patients, potentially affecting treatment outcomes.
Purpose of the Study:
- To evaluate the nutritional status of newly diagnosed pediatric cancer patients.
- To assess the relationship between nutritional status and treatment response, complications, and survival.
Main Methods:
- Anthropometric, hematological, and biochemical parameters were assessed in 44 children with newly diagnosed malignancy before therapy.
- Nutritional status was categorized using weight-for-age criteria.
- Treatment response and survival were monitored during follow-up.
Main Results:
- Over half (56.8%) of the children exhibited malnutrition based on weight-for-age.
- Low hemoglobin (82%), low total proteins (25%), low serum albumin (20.5%), low serum transferrin (27.3%), and low serum iron (16.3%) were common.
- Malnourished children had significantly lower remission/response rates (38.1% vs. 69.5%), more therapy delays (38.1% vs. 8.7%), and higher mortality (61.9% vs. 30.5%).
- Complications like febrile neutropenia and bleeding were more frequent in malnourished children.
- Infection incidence was higher in children with low serum iron (<60μg/dL) (42.8% vs. 8%).
Conclusions:
- Nutritional status is a critical factor influencing treatment outcomes in pediatric cancer.
- Malnourished children experience worse treatment responses, increased complications, and higher mortality.
- Routine nutritional assessment and intervention are recommended for improving survival and quality of life in pediatric oncology patients.
Abstract:
The study was conducted in the Departments of Pediatric Haemato-Oncology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh from January 2007 to May 2009. Total 44 children (34 males and 10 females) aged between 10 months and 12 years with newly diagnosed malignancy. Nutritional status of 44 children with newly diagnosed malignancy was evaluated by anthropometric, hematological results 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 <-2z). Low hemoglobin was found in 82% children, 25% had low total proteins (<5.7g/dL), 20.5% low serum albumin (<3.2g/dL), 27.3% low serum transferrin (<210mg/dL) and 16.3% low serum iron (<60μg/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 <60μg/dL than those with higher values of serum iron (42.8% vs. 8%).
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