Nutritional state alterations in children with acute lymphoblastic leukemia during induction and consolidation of chemotheraphy

RESUMEN

The objective of the study was to determine if children with high risk acute lymphoblastic leukemia (ALL) exhibit higher frequency of alterations in nutritional state during the phases ofinduction and consolidation of chemotherapy than children with low risk ALL, based on the arm muscle area. The design was concurrent comparative cohort. It was performed at pediatric hematology service of the Hospital General del Centro Medico Naciona "La Raza" and hematology service of the Hospital de Pediatria del Centro Medico Nacional "Siglo XXI". One hundred-five patients were incorporated into the study 53 with high risk (HR) ALL and 52 with low risk (LR) ALL. Basal measurements of arm circunference and tricipital skinfold were surveyed monthly (for 3 months) by standardized personnel. Altered nutritional state during follow-up was defined as the loss of 10 percent or more of the arm muscular area (AMA) measured at diagnosis. Statistics of proportion analysis with a significance level of 0.05 and relative risk (RR) was 0.77 (CI 0.31-1.87); the LR group was the most affected. In the second month the RR was 7.31 (CI 1.41-38.03); the most affected group was the HR. In the third month the RR was 1.77 (CI 0.60-4.92); the HR group was the most affected. High-risk patients show a higher frequency of nutritional state alterations reflected in AMA during the second month after diagnosis. This may be caused by the more aggressive chemotherapy received by these patients