Malnutrition as a prognostic factor in lymphoblastic leukaemia: a multivariate analysis

Area of Science:

• Pediatric Oncology
• Hematology
• Global Health

Background:

• lymphoblastic leukemia (ALL) is a significant childhood cancer globally.
• Treatment protocols like the Berlin-Frankfurt-Munich (BFM) are standard for ALL.
• Developing countries face unique challenges in pediatric cancer care, including nutritional status.

Purpose of the Study:

• To evaluate prognostic factors for relapse-free survival in Brazilian children with ALL.
• To investigate the impact of malnutrition on treatment outcomes.
• To identify key indicators for improved prognostic assessment in resource-limited settings.

Main Methods:

• A cohort of 128 Brazilian children with ALL were treated using a BFM-based protocol.
• Statistical analysis, including Cox's multivariate model, was employed to assess prognostic factors.
• Nutritional indices, specifically height-for-age and weight-for-age z-scores, were analyzed.

Main Results:

• The overall estimated relapse-free survival was 41% after a median follow-up of 31 months.
• Malnutrition emerged as the most significant adverse prognostic factor for complete remission duration.
• Children with a height-for-age z-score below -2 exhibited a substantially increased risk of relapse (8.2-fold).

Conclusions:

• Socioeconomic and nutritional status are critical determinants of treatment success for childhood ALL in developing nations.
• Nutritional interventions and assessments should be integrated into prognostic evaluations for pediatric leukemia patients.
• Height-for-age z-score is a particularly strong predictor of relapse-free survival in this population.