Related Experiment Video
Updated: Jun 24, 2026
Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
Effect of nutritional screening in children with acute lymphoblastic leukemia undergoing the maintenance chemotherapy
Xuefen Zhao1, Juan Wang1, Li Chen1
1Department of Hematology, Children's Hospital of Nanjing Medical University, No. 72 Guangzhou Road, Gulou District, Nanjing City, Jiangsu Province, 210000, China.
Insights
Routine nutritional screening for hospitalized children with acute lymphoblastic leukemia (ALL) improved event-free survival (EFS) and immune function. This intervention led to better long-term outcomes and quality of life for pediatric cancer patients.
Area of Science:
- Pediatric Oncology
- Clinical Nutrition
- Health Outcomes Research
Background:
- Malnutrition is a significant concern for hospitalized children with acute lymphoblastic leukemia (ALL) undergoing maintenance chemotherapy.
- Nutritional status can impact treatment efficacy and overall clinical outcomes in pediatric cancer patients.
Purpose of the Study:
- To evaluate the effectiveness of routine nutritional screening in hospitalized pediatric ALL patients on maintenance chemotherapy.
- To assess the impact of nutritional screening on clinical outcomes, including event-free survival (EFS), immune function, and quality-adjusted life years (QALYs).
Main Methods:
- A retrospective, propensity score-matched superiority study involving 1038 pediatric patients.
- Patients were divided into a screening cohort (received nutritional screening) and a control cohort (usual care without screening) using 1:1 propensity score matching.
- Primary endpoint was long-term EFS; secondary outcomes included immune function, complications, and QALYs.
Main Results:
- Nutritional screening identified 25.8% of patients at risk for malnutrition.
- The screening cohort showed higher serum albumin levels and improved cellular immune function compared to the control cohort.
- Patients in the screening cohort had significantly lower event rates (28.6% vs. 46.5%) and better long-term EFS (log-rank p < 0.001).
- Quality-adjusted life years (QALYs) were significantly higher in the screening cohort post-discharge.
Conclusions:
- Routine, child-specific nutritional screening during hospitalization improves EFS in pediatric ALL patients.
- Nutritional screening positively impacts immune function and long-term quality of life in this population.
Background:
To investigate the effectiveness of the routine nutritional screening for malnutrition risk in hospitalized children with acute lymphoblastic leukemia (ALL) on maintenance chemotherapy from the viewpoint of clinical outcomes.
Methods:
The reviews of 1038 pediatric patients were retrieved for the retrospective, propensity score-matched, superiority study. A 1:1 propensity score matching was utilized to match patients who received nutritional screening (screening cohort) to those who remained usual care without screening (control cohort). The primary endpoint was the long-term event-free-survival (EFS) after the last cycle of maintenance. Secondary outcomes included immune function, complications and long-term quality-adjusted life years (QALYs).
Results:
The proportion of cases with risk of malnutrition in screening was 25.8%. At the end of 4 weeks following the last cycle, the level of serum albumin was higher in screening cohort than control cohort (p < 0.001), while the cellular immune function significantly improved in screening cohort (all p < 0.05). During a mean of 11.09 ± 6.45 months follow-up, 28.6% of patients in screening cohort had an event including ALL-related emergency visits, readmitted hospitalizations and severe infections compared to 46.5% of cases in control cohort yielding a hazard ratio of 0.397 (95%CI: 0.306, 0.493 and a significant difference in long-term EFS (24.07 (95%CI: 23.09, 25.04) vs. 18.02 (95%CI: 16.62, 19.42), log-rank p < 0.001). The means of QALYs calculated by area under the curve up to 3, 6, 12 and 24 months after discharge were significantly lower in screening cohort as opposed to control cohort (all p < 0.05).
Conclusions:
Pediatric ALL receiving the specific-for-children nutritional screening during hospitalization exhibited a better EFS over the 24-month follow-up than cases without screening. The benefit accounted for a significant improvement in immune function and QALYs scores over long-term follow-up.
Clinical Trial Number:
Not applicable.
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:28Chronic Kidney Disease III: Interprofessional Care