Alterations of Nutritional Status in Children and Adolescents with Acute Lymphoblastic Leukemia

Abstract

Malnutrition is often observed in pediatric cancer patients and has been recognized as a risk factor for relapse and survival. Maintaining an appropriate nutritional status during anticancer treatment has, therefore, been more and more frequently perceived as an additional requirement for optimal therapy outcomes. The aim of our study was to establish alterations of nutritional status in 26 children and adolescents treated for acute lymphoblastic leukemia (ALL) at the Children's Hospital in Zagreb, Croatia, between 2016 and 2021, by using anthropometric measures and serum albumin levels. The majority of patients (53.8% female, median 4 years, 52.2% intermediate-risk leukemia group) had normal weight at the beginning of chemotherapy. The percentage of overweight/obese patients increased from 4.2% at diagnosis to 37.5% at the end of intensive therapy. Apart from a significant increase in body weight (BW) and body mass index (BMI) for age, a notable decline in body height/body length (BH/BL) for age in the observed period was recorded, especially in high-risk leukemia patients. The alterations in serum albumin values were not significant, nor was their correlation with BMI. Dietary consultation was offered to all patients, while children with a decline in BMI and BH/BL received additional nutritional support.

Keywords: acute lymphoblastic; anthropometry; body mass index; children; leukemia; nutritional status.

Figure 1

Study design. Abbreviations: TP—time point; BH—body height; BL—body length; BW—body weight; BMI—body mass index.

Figure 2

Graphical representation of nutritional status of patients at time points of interest. Abbreviations: TP—time point.

Figure 3

Body height/length z-score at different time points between standard-, intermediate- and high-risk groups. Abbreviations: TP—time-point.