Adherence to Oral Nutritional Support and Its Effect on Nutritional Status in Pediatric Oncology Patients

Children with cancer frequently suffer from malnutrition caused by their disease and treatments. This study examines the rates of malnutrition, compliance with nutritional therapy, and its impact on nutritional status in pediatric cancer patients. This multicenter cross-sectional study was conducted between 2021 and 2023 at 12 pediatric hematology and oncology clinics. This study included 385 patients (aged 0.3-18 years) with leukemia-lymphoma and solid tumors that are currently on or had newly started oral nutritional supplement (ONS) treatment. Anthropometric measurements, mid-upper-arm-circumference (MUAC), body mass index (BMI), weight-for-age (WFA), were collected, and malnutrition risk was evaluated by the nutrition screening tool for childhood cancer (SCAN). Baseline WFA-based malnutrition was 31.0%, increasing to 38.5%, while SCAN≥3 was 83.8% decreasing to 72.4% at the sixth month. Malnutrition risk was more common in sarcoma and central nervous system tumor patients. ONS adherence decreased across all cancer types during the follow-up period. Adherent patients demonstrated higher BMI scores during the study period and MUAC z-scores in the last 2 months compared to the non-adherent group (P < 0.04). Our study demonstrates that the use of validated nutrition screening tools, together with adherence strategies, can lead to increased weight-for-age and lower malnutrition risk screening scores.