Nutritional status of children with leukemia

Abstract

Children with cancer represent a high-risk group for protein-energy malnutrition due to side effects associated with treatment. Assessment of nutritional status at the time of diagnosis and during treatment is, therefore, essential for planning nutritional intervention. We studied the nutritional status of 25 children with leukemia [9 newly diagnosed/relapsed (D/R) leukemic patients and 16 children with leukemia in remission (REM)]. Plasma proteins (prealbumin, PA; albumin, Alb; transferrin, Tr; retinol-binding protein, RBP) and acute phase-reactant proteins (alpha 1-acid glycoprotein, AGP; C-reactive protein, CRP; ceruloplasmin, CER) were measured by radial immunodiffusion. Results show that there were no significant deficits in anthropometric measurements among leukemic children. In contrast, the mean levels of all plasma proteins, especially PA (P < 0.005), were significantly lower in the D/R group than in the REM group. All D/R children, compared to 59% of those in remission, had PA levels < 20 mg/dl. Only the D/R group had abnormal levels of RBP, Tr, and Alb. Children who were treated with prednisone had significantly higher mean levels of PA, RBP, and AGP than those who were not receiving prednisone. The mean levels of acute phase-reactant proteins in these leukemic children were comparable to those of healthy children. We conclude that mild/moderate malnutrition is common in leukemic patients at D/R and that PA seems to be the most sensitive indicator of visceral protein status.

Nutritional Assessment of Children with Acute Lymphoblastic Leukemia

“…In this Indian study show that there is 13 (52%) patients out of these 25 newly diagnosed ALL were underweight at presentation, twelve patients (48%) were wasted. Nine (36%) of them were malnourished according to MUAC [16]. Our study is comparable Rajesh et al study [17].…”

“…et al was carried out on study group comprised 25 children with newly diagnosed ALL, their age range from (1-12) year, eighteen of them are male and seven are females [16]. In this Indian study show that there is 13 (52%) patients out of these 25 newly diagnosed ALL were underweight at presentation, twelve patients (48%) were wasted.…”

“…There was a great effect of prednisolone during the weeks of induction by increase food intake, which related to relieve of symptoms and euphoria, over caring for children during illness period and over introduction of best food by the parents [16].…”

“…Corticosteroid therapy causes alteration in fat metabolism, which had a net effect of increase body fat and redistribution of body fat causing truncal obesity [16].…”

The Effectiveness of Enteral Nutrition Support in the Growth of Children Patients with Cancer

“…Kibirige et al [10] reported that median weight:height ratio and serum albumin concentrations may be useful measurements in children newly diagnosed with leukemia to indicate which patients will require supplementary nutrition. Yu et al [15] also reported that low plasma protein concentrations can be ascribed to mild malnutrition in children with newly diagnosed or relapsed leukemia. Merritt et al [16] reported similar results in pediatric cancer patients, suggesting that abnormal serum albumin is a more common indicator of acute metabolic response to fever and infection than decreased body mass.…”