Background Acute lymphoblastic leukemia (ALL) is the most common malignancy in children and adolescents. Febrile Neutropenia (FN) is a medical emergency on ALL that often leads to death. Nutrition status assessment on ALL patient is important because malnutrition can reduce the tolerance of chemotherapy, increase incidence of infection and decrease survival rate. Objectives To assess malnutrition as a risk factor for FN in children with ALL. Methods This case-control study was performed at Sardjito Hospital, Yogyakarta on patients aged 1 month to 18 years diagnosed with ALL and undergoing induction phase chemotherapy between January 2013 and December 2015. The case and control subjects were children with and without FN, respectively. Febrile neutropenia was confirmed by patients temperature above 38ºC at one measurement and a peripheral neutrophil count of less than 1,000/mm3. Malnutrition was defined as body weight-for-height was between -2 and <-3 standard deviation. Subjects were included using simple random sampling. Result Bivariate analysis showed a significant correlation between malnutrition and FN (OR 2.62; 95%CI 1.07 to 6.45; P=0.03). However, there was no inverse correlation between socioeconomic status and FN (OR 1.1; 95%CI 0.42 to 2.41; P=0.83). There was no correlation between nutritional status and duration of FN (P= 0.48).   Conclusion Malnutrition is a risk factor for FN in children with acute lymphoblastic leukemia.

Latar belakang. Leukemia limfoblastik akut (LLA) merupakan keganasan yang sering ditemukan pada anak dan remaja. Demam neutropeni (DN) merupakan kedaruratan medik pada LLA yang sering menyebabkan kematian.Tujuan. Mengetahui angka kejadian dan kematian DN pada LLA anak selama terapi fase induksi.Metode. Penelitian deskriptif dengan disain potong lintang. Subjek adalah pasien LLA anak pada kurun Januari 2013 hingga Desember 2015, usia 1 bulan hingga 18 tahun dan tengah menjalani terapi fase induksi. Neutropeni ditegakkan dengan jumlah neutrofil absolut <1.500/mmk. Pengambilan sampel dilakukan secara consecutive sampling.Hasil. Terdapat 246 kasus LLA baru pada kurun waktu penelitian, 115 (46,7%) mengalami DN selama fase induksi. Kematian terjadi pada 15/115 (13%) kasus, 9/15 (60%) berhubungan dengan DN (sepsis, syok sepsis), sisanya karena sebab lainnya (sindrom lisis tumor, herniasi dan infiltrasi mening). Analisis pada kasus yang rekam mediknya selama fase induksi lengkap (59/115 atau 51,3%) menunjukkan 50/59 (84%) subjek mengalami satu kali kejadian DN, sisanya 9/59 (16%) mengalaminya 2-3 kali. Median terjadinya DN kali pertama setelah diagnosis adalah 8 hari (0-62 hari). Median durasi DN 7 hari (3-23).Kesimpulan. Kejadian demam neutropeni selama fase induksi masih tinggi dan merupakan penyebab kematian yang paling utama.