Assessment of Nutrition Status in Children with Leukemia: A Study from a Developing Country

Background: In developing countries 40 % children suffer from mal-nutrition. It has been shown that a good nutritional status can reduce complications of treatment, strengthen the immune system and contribute to the patient’s general well being throughout treatment. A good nutritional status is therefore essential for optimal treatment of a leukemic child. The aim of our study was to see the nutritional status of leukemic children on diagnosis and effect of nutrition on outcome of therapy.

Material & Methods: During period from January 2004 to December 2007 we prospectively analyzed the nutritional status of 400 paediatric patients in Netaji Subhash Chandra Bose Cancer Research Institute, a tertiary cancer center of Eastern India. The age of the patients were 1 to 18 years (median age 12.5 years). The parameter analyzed were weight for age, height for age, total protein, serum albumin and skin fold thickness. The weight for age, height for age and skin fold thickness were taken as normal if they were between 3^rd and 97^th percentile curve of the growth chart recommended by the Indian Council of Medical Research. The albumin level and the total protein was considered normal if the value is equal to or more than 3gm% and 5.8gm% respectively.

Result: It was seen that total 56 patients (14% children) were low weight for age, 40 patients (10% children) were low height and 67 patients (16.75% children) had low mid arm circumference. Total 44 patients (11% children) had low serum albumin while 80 patients (20% children) had low serum protein. It was found that low weight for age, low serum albumin and low mid arm circumference were significance factors in remission induction, disease free survival and toxicity of chemotherapy (p < 0.005).

Conclusion: We conclude that mal-nutrition is a major finding in cancer patients with leukemia in developing country like ours. The patient with mal-nutrition had less remission in induction, disease free survival and more toxicities during therapy as compared to well-nourished children.