title: Nutritional status at diagnosis is related to clinical outcomes in children and adolescents with cancer: a perspective from Central America.
abstract: BACKGROUND
  The prevalence of malnutrition in children may exceed 50% in countries with limited resources. The aims of this study were to assess nutritional status at diagnosis in children and adolescents with cancer, and to correlate it with clinical outcomes in the Spanish speaking countries of Central America that formed the AHOPCA (Asociacion de Hemato-Oncologia Pediatrica de Centro America) consortium.
  
  
  METHODS
  Patients aged 1-18 years, diagnosed with cancer between 1st October 2004 and 30th September 2007, were eligible for study. Weight (kg) and height or length (m), mid upper arm circumference--MUAC and triceps skin fold thickness--TSFT were measured and their Z-scores or percentiles were calculated. Three categories of nutritional status were defined according to these parameters.
  
  
  RESULTS
  A total of 2954 new patients were enrolled; 1787 had all anthropometric measurements performed and 1513 also had measurements of serum albumin. By arm anthropometry 322/1787 patients (18%) had moderate nutritional depletion and 813/1787 patients (45%) were severely depleted. Adding serum albumin, the proportion classified as severely depleted rose to 59%. Malnourished children more often abandoned therapy and their event free survival was inferior to that of other children.
  
  
  CONCLUSIONS
  Arm anthropometry in children with cancer is a sensitive measure of nutritional status. Since malnutrition at diagnosis was related to important clinical outcomes, an opportunity exists to devise simple, cost-effective nutritional interventions in such children that may enhance their prospects for survival.
authors: Department of Pediatrics, S Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
authors: Alessandra
authors: A
authors: Sala
authors: Emanuela
authors: E
authors: Rossi
authors: Federico
authors: F
authors: Antillon
authors: Ana Lucia
authors: AL
authors: Molina
authors: Tania
authors: T
authors: de Maselli
authors: Miguel
authors: M
authors: Bonilla
authors: Angelica
authors: A
authors: Hernandez
authors: Roberta
authors: R
authors: Ortiz
authors: Carlos
authors: C
authors: Pacheco
authors: Rosa
authors: R
authors: Nieves
authors: Marta
authors: M
authors: Navarrete
authors: Max
authors: M
authors: Barrantes
authors: Paul
authors: P
authors: Pencharz
authors: Maria Grazia
authors: MG
authors: Valsecchi
authors: Ronald
authors: R
authors: Barr
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001132:Arm / Q000033:anatomy & histology; D001827:Body Height; D001835:Body Weight; D002489:Central America / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D009752:Nutritional Status; D015995:Prevalence; D012885:Skinfold Thickness