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. 2022 Jul 28:9:899501.
doi: 10.3389/fnut.2022.899501. eCollection 2022.

Association between malnutrition and leucopenia in patients with osteosarcoma

Haixiao Wu  1   2 , Shu Li  2   3 , Yile Lin  2   4 , Jun Wang  2   5 , Vladimir P Chekhonin  2   6 , Karl Peltzer  2   7 , Vladimir P Baklaushev  2   8 , Kirellos Said Abbas  2   9 , Jin Zhang  1   2 , Huiyang Li  2   10 , Chao Zhang  1   2
Affiliations

Association between malnutrition and leucopenia in patients with osteosarcoma

Haixiao Wu et al. Front Nutr. .

Abstract

Background and aim: Leucopenia (LP) greatly limits the efficacy of chemotherapy in osteosarcoma patients. This study aimed to evaluate the nutritional status of osteosarcoma patients before chemotherapy, assess the risk of LP during the perichemotherapy period, and explore the association between malnutrition and LP.

Materials and methods: This study retrospectively analyzed osteosarcoma patients treated in the Tianjin Medical University Cancer Institute and Hospital, China, between January 2009 and December 2020 according to the inclusion and exclusion criteria. Malnutrition in adolescents (5 to 19 years old) and adults (≥20 years old) was diagnosed using WHO AnthroPlus software (version 1.0.4) and Global Leadership initiative on Malnutrition (GLIM), respectively. According to the diagnostic criteria of LP in CTCAE 5.0, patients were divided into the LP group and the non-LP group.

Results: A total of 245 osteosarcoma patients were included. The incidence of malnutrition was 49.0%, and the incidence of LP was 51.8%. The incidence of malnutrition in adolescent patients was 53.1%, and their incidence of LP was 55.2%; the incidence of malnutrition in adult patients was 43.1%, and their incidence of LP was 47.1%. Logistic regression analysis showed that malnutrition before chemotherapy was an independent risk factor for the occurrence of LP after chemotherapy (OR = 6.85, 95% CI = 2.16-25.43; and OR = 35.03, 95% CI = 6.98-238.46 in mildly and severely malnourished young patients; OR = 6.06; 95% CI = 1.43-30.16; and OR = 38.09, 95% CI = 7.23-285.78 in mildly and severely malnourished adult patients, respectively). The results showed that age and nutritional status had a joint effect on the occurrence of LP.

Conclusion: The nutrition status of osteosarcoma patients before chemotherapy is significantly correlated with the occurrence and severity of LP during peri-chemotherapy period. During osteosarcoma chemotherapy, necessary nutritional support should be given to patients of different ages to correct their malnutrition status in a timely manner, ultimately improving the efficacy of chemotherapy and the prognosis of patients.

Keywords: chemotherapy; leucopenia; malnutrition; osteosarcoma; retrospective study.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of the enrolled patients.
FIGURE 2
FIGURE 2
(1) The correlation between (A) Z-score of adolescents, (B) body mass index (BMI) of adults, (C) C-reactive protein (CRP) of adults, and white blood cell (WBC) levels after chemotherapy. (2) Receiver-operating characteristics (ROC) curves identifying discrimination thresholds of (D) Z-score of adolescents, (E) body mass index (BMI) of adults, (F) C-reactive protein (CRP) of adults for Leucopenia (LP).
FIGURE 3
FIGURE 3
Severity (A) and frequency (B) of nutritional status and occurrence of LP in adolescent patients. Severity (C) and frequency (D) of nutritional status and occurrence of LP in adult patients. The results showed that the severity and frequency of LP increased with the deterioration of patients’ nutritional status. LP: Leucopenia.
FIGURE 4
FIGURE 4
Joint effect of age and the nutritional status on the risk of LP. The results showed that the risk of severe LP increased with the increased age and the worse nutritional status. LP: Leucopenia.
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References

    1. Miller KD, Fidler-Benaoudia M, Keegan TH, Hipp HS, Jemal A, Siegel RL. Cancer statistics for adolescents and young adults, 2020. CA Cancer J Clin. (2020) 70:443–59. 10.3322/caac.21637 - DOI - PubMed
    1. Zeng M, Zhou J, Wen L, Zhu Y, Luo Y, Wang W. The relationship between the expression of Ki-67 and the prognosis of osteosarcoma. BMC Cancer. (2021) 21:210. 10.1186/s12885-021-07880-y - DOI - PMC - PubMed
    1. Siegel R, Miller K, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. (2020) 70:7–30. 10.3322/caac.21590 - DOI - PubMed
    1. Howard SC, McCormick J, Pui CH, Buddington RK, Harvey RD. Preventing and managing toxicities of high-dose methotrexate. Oncologist. (2016) 21:1471–82. 10.1634/theoncologist.2015-0164 - DOI - PMC - PubMed
    1. Lewis S, Chopra S, Naga P, Pant S, Dandpani E, Bharadwaj N, et al. Acute hematological toxicity during post-operative bowel sparing image-guided intensity modulated radiation with concurrent cisplatin. Br J Radiol. (2018) 91:20180005.10.1259/bjr.20180005 - DOI - PMC - PubMed

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