title: Malnutrition in childhood cancer patients: a review on its prevalence and possible causes.
abstract: OBJECTIVE
  To perform a systematic literature review for critical evaluation of prevalence and factors contributing to malnutrition in childhood cancer.
  
  
  METHODS
  A systematic search resulting in 46 suitable articles.
  
  
  RESULTS
  Due to lack of uniform criteria and adequate studies, the prevalence rates of malnutrition can only be estimated. Based on strengths and weaknesses of included references, prevalence rates are estimated to be 0-10% for leukemia, 20-50% for neuroblastoma, and 0-30% for other malignancies. Whether energy deficiency or inflammation contributed to malnutrition could not be confirmed because the occurrence of energy deficit (low energy intake, increased metabolic rate) or inflammation (related to cachexia) was not convincing. Also, a relationship between these factors and malnutrition was not studied.
  
  
  CONCLUSIONS
  Longitudinal studies are needed to determine which children are at risk of malnutrition, and to investigate the impact of energy deficiency and inflammation on the nutritional status and body composition of childhood cancer patients.
authors.affiliation: UMCG School of Nursing and Health, University Medical Center Groningen, University of Groningen, The Netherlands. a.brinksma@umcg.nl
authors.forename: Aeltsje
authors.initials: A
authors.lastname: Brinksma
authors.forename: Gea
authors.initials: G
authors.lastname: Huizinga
authors.forename: Esther
authors.initials: E
authors.lastname: Sulkers
authors.forename: Willem
authors.initials: W
authors.lastname: Kamps
authors.forename: Petrie
authors.initials: P
authors.lastname: Roodbol
authors.forename: Wim
authors.initials: W
authors.lastname: Tissing
mesh_terms: D002648:Child; D015362:Child Nutrition Disorders / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology / Q000378:metabolism; D002149:Energy Intake; D004734:Energy Metabolism; D006801:Humans; D007249:Inflammation / Q000276:immunology; D009369:Neoplasms / Q000150:complications*; D015995:Prevalence; D012307:Risk Factors