title: Nutritional state alterations in children with acute lymphoblastic leukemia during induction and consolidation of chemotherapy.
abstract: 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 of induction and consolidation of chemotherapy than children with low risk ALL, based on the arm muscle area. The design was concurrent comparative cohorts. It was performed at pediatric hematology service of the Hospital General del Centro Médico Nacional "La Raza" and hematology service of the Hospital de Pediatría del Centro Médico 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 circumference 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% 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) with confidence intervals (CI) were calculated. In the first month the 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.
authors.affiliation: Unidad de Investigación Médica en Epidemiología Clínica, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F.
authors.forename: J M
authors.initials: JM
authors.lastname: Mejía-Arangure
authors.forename: A
authors.initials: A
authors.lastname: Fajardo-Gutíerrez
authors.forename: R
authors.initials: R
authors.lastname: Bernáldez-Ríos
authors.forename: M C
authors.initials: MC
authors.lastname: Rodríguez-Zepeda
authors.forename: L
authors.initials: L
authors.lastname: Espinoza-Hernández
authors.forename: M C
authors.initials: MC
authors.lastname: Martínez-García
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001132:Arm / Q000473:pathology; D001215:Asparaginase / Q000008:administration & dosage / Q000009:adverse effects; D001824:Body Constitution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D004734:Energy Metabolism; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000150:complications; D006769:Hospitals, General; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage / Q000009:adverse effects; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D009748:Nutrition Disorders / Q000209:etiology*; D009752:Nutritional Status; D009765:Obesity / Q000150:complications; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D012306:Risk; D012885:Skinfold Thickness; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D003561:Cytarabine; D015251:Epirubicin; D014750:Vincristine; D015122:Mercaptopurine; D001215:Asparaginase; D011241:Prednisone; D008727:Methotrexate