Nutritional status in children with acute lymphoblastic leukemia, and its correlation with severe infection
Rimjhim Sonowal, Vineeta Gupta
Department of Pediatrics, Division of Hematology Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
Background: Undernutrition is a common childhood problem in India which may contribute to higher risk of infection and lower survival rate in children with acute lymphoblastic leukemia (ALL).
Methods: In our study, we retrospectively included patients of age group 1-15 years who were treated for ALL and survived induction. Data on weight, height and serum albumin levels recorded at the time of diagnosis of the patients were used in this study. For defining acute undernutrition we used weight-for-height, weight-for-age criteria for children ≤5 years and body mass index for age >5 years. We correlated nutritional status of the patients with severe infection and mortality percentage.
Results: There were 101 patients with male:female ratio of 2.4:1. Forty-four children were ≤5 years and 57 children were >5 years of age. It was found that 74 children had B-cell ALL and 17 children had T-cell ALL; 54 patients were stratified as high-risk and 47 as standard-risk. In all, 52.5% patients had acute undernutrition at diagnosis. In ALL patients with acute undernutrition, severe infection was found to be 10.8% higher than ALL patients with normal nutrition which was statistically insignificant. Male children and children with serum albumin level <3.5 g/dL in the acute undernutrition group had higher risk of infection. Mortality percentage of patients with baseline acute undernutrition was found to be higher by 11% than normal nutrition group (P-value = 0.21).
Conclusion: Our study highlights the magnitude of undernutrition at diagnosis in ALL patients in a tertiary care centre. It also correlates nutritional status with severe infection and mortality in follow-up.
Department of Pediatrics, Division of Hematology Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh
Source of Support: None, Conflict of Interest: None