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Review
. 2024 Apr 28;16(9):1327.
doi: 10.3390/nu16091327.

Managing Undernutrition in Pediatric Oncology: A Consensus Statement Developed Using the Delphi Method by the Polish Society for Clinical Nutrition of Children and the Polish Society of Pediatric Oncology and Hematology

Agnieszka Budka-Chrzęszczyk  1 , Agnieszka Szlagatys-Sidorkiewicz  1 , Ewa Bień  2 , Ninela Irga-Jaworska  2 , Anna Borkowska  1 , Małgorzata Anna Krawczyk  2 , Katarzyna Popińska  3 , Hanna Romanowska  4 , Ewa Toporowska-Kowalska  5 , Magdalena Świder  6 , Jan Styczyński  7 , Tomasz Szczepański  8 , Janusz Książyk  3
Affiliations
Review

Managing Undernutrition in Pediatric Oncology: A Consensus Statement Developed Using the Delphi Method by the Polish Society for Clinical Nutrition of Children and the Polish Society of Pediatric Oncology and Hematology

Agnieszka Budka-Chrzęszczyk et al. Nutrients. .

Abstract

"Managing Undernutrition in Pediatric Oncology" is a collaborative consensus statement of the Polish Society for Clinical Nutrition of Children and the Polish Society of Pediatric Oncology and Hematology. The early identification and accurate management of malnutrition in children receiving anticancer treatment are crucial components to integrate into comprehensive medical care. Given the scarcity of high-quality literature on this topic, a consensus statement process was chosen over other approaches, such as guidelines, to provide comprehensive recommendations. Nevertheless, an extensive literature review using the PubMed database was conducted. The following terms, namely pediatric, childhood, cancer, pediatric oncology, malnutrition, undernutrition, refeeding syndrome, nutritional support, and nutrition, were used. The consensus was reached through the Delphi method. Comprehensive recommendations aim to identify malnutrition early in children with cancer and optimize nutritional interventions in this group. The statement underscores the importance of baseline and ongoing assessments of nutritional status and the identification of the risk factors for malnutrition development, and it presents tools that can be used to achieve these goals. This consensus statement establishes a standardized approach to nutritional support, aiming to optimize outcomes in pediatric cancer patients.

Keywords: childhood cancer; nutrition; nutritional support.

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Conflict of interest statement

Author M.Ś. has received sponsored attendance at scientific conferences and has conducted lectures for Nutricia and Nestle. Author A.B.-C. has received sponsored attendance at scientific conferences from Nutricia. Author A.B. has received a speaker honorarium from Nestle. Author A.S.-S. has received sponsored attendance at scientific conferences for Nutricia, Nestle, and Fresenius Kabi, and has received a speaker honorarium from Nutricia and Nestle. Author E.B. and N.I.-J. have received a speaker honorarium from Nutricia. Author H.R. has received sponsored attendance at scientific conferences from Fresenius Kabi. This financial support may be perceived as a potential conflict of interest. Nevertheless, the funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. The other authors declare no conflicts of interest.

Figures

Figure 2
Figure 2
Indications for nutritional intervention (acc. to [16,17,33]; own elaboration).
Figure 1
Figure 1
Clinical signs of malnutrition, own elaboration.
Figure 3
Figure 3
Nutritional intervention (step-up approach).
Figure 4
Figure 4
Side effects of the anticancer and supportive treatment associated with gastrointestinal tract and metabolic dysfunctions.
Figure 5
Figure 5
Decision algorithm for choosing the type of nutritional treatment concerning the current functioning of the patient’s gastrointestinal tract.
Figure 6
Figure 6
Types of gastrointestinal tract accesses.
Figure 7
Figure 7
Classification of enteral formulas for children according to their age [33].
Figure 8
Figure 8
The enteral nutrition formulas regarding the calories and protein content.
See this image and copyright information in PMC

References

    1. Bauer J., Jürgens H., Frühwald M.C. Important Aspects of Nutrition in Children with Cancer. Adv. Nutr. 2011;2:67–77. doi: 10.3945/an.110.000141. - DOI - PMC - PubMed
    1. Joffe L., Schadler K.L., Shen W., Ladas E.J. Body composition in pediatric solid tumors: State of the science and future directions. J. Natl. Cancer Inst. Monogr. 2019;1:144–148. doi: 10.1093/jncimonographs/lgz018. - DOI - PMC - PubMed
    1. Kadenczki O., Nagy A.C., Kiss C. Prevalence of Undernutrition and Effect of Body Weight Loss on Survival among Pediatric Cancer Patients in Northeastern Hungary. Int. J. Environ. Res. Public Health. 2021;18:1478. doi: 10.3390/ijerph18041478. - DOI - PMC - PubMed
    1. Lange B.J., Gerbing R.B., Feusner J., Skolnik J., Sacks N., Smith F.O., Alonzo T.A. Mortality in overweight and underweight children with acute myeloid leukemia. JAMA. 2005;293:203–211. doi: 10.1001/jama.293.2.203. - DOI - PubMed
    1. Loeffen E.A., Brinksma A., Miedema K.G., de Bock G.H., Tissing W.J. Clinical implications of malnutrition in childhood cancer patients—Infections and mortality. Support. Care Cancer. 2015;23:143–150. doi: 10.1007/s00520-014-2350-9. - DOI - PubMed

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