title: Nutritional status of children during treatment for acute lymphoblastic leukemia in Guatemala.
abstract: BACKGROUND
  Most children with cancer live in developing countries where the prevalence of malnutrition may reach 50% and influence the course of the disease. This study examined the prevalence and severity of malnutrition at diagnosis, as well as after 3 and 6 months of chemotherapy, in children with acute lymphoblastic leukemia (ALL) in Guatemala.
  
  
  METHODS
  Triceps skin fold thickness (TSFT) and mid upper arm circumference (MUAC) provided measures of nutritional status (NS) in three categories: adequately nourished (A): TSFT and MUAC > 10th percentile; severely depleted (SD): TSFT or MUAC < 5th percentile; and moderately depleted (MD): all the remaining patients.
  
  
  RESULTS
  Of 331 new patients, 241 had NS assessed at diagnosis. A = 113 (46.9%); MD = 28 (11.6%); SD = 100 (41.5%). At 3 months A = 106 (52.2%); MD = 25 (12.3%); SD = 72 (35.5%). At 6 months A = 146 (76.0%); MD = 12 (6.3%); SD = 34 (17.7%). In multivariate analysis, SD children at 6 months of treatment had a hazard of death that was 2.4-fold the hazard of those A or MD (95% CI: 1.3-4.7)
  
  
  CONCLUSIONS
  Malnutrition is prevalent in newly diagnosed children with ALL in Guatemala and severe nutritional depletion is apparently predictive of abandonment of therapy and relapse of disease, but if children survive and improve their NS in the first 6 months after diagnosis, their chances of survival may improve significantly to approximate those in children not presenting with nutritional depletion.
authors.affiliation: Unidad Nacional de Oncologia Pediatrica, Guatemala City, Guatemala.
authors.forename: Federico
authors.initials: F
authors.lastname: Antillon
authors.forename: Emanuela
authors.initials: E
authors.lastname: Rossi
authors.forename: Ana Lucia
authors.initials: AL
authors.lastname: Molina
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sala
authors.forename: Paul
authors.initials: P
authors.lastname: Pencharz
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Valsecchi
authors.forename: Ronald
authors.initials: R
authors.lastname: Barr
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D015362:Child Nutrition Disorders / Q000453:epidemiology*; D002675:Child, Preschool; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D009752:Nutritional Status; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D015995:Prevalence; D016016:Proportional Hazards Models; D012885:Skinfold Thickness
chemical_list: D000970:Antineoplastic Agents