The Effect of Induction Chemotherapy and Socioeconomic Status on The Prevelance of Malnutrition among Pediatric Leukemia Patients.

Objectives: The aim of this study is to identify malnutrition status among pediatric patients newly diagnosed with leukemia and assess nutritional deterioration during induction therapy and to determine its relation with the socioeconomic status.  Methods: A prospective study was conducted, including 105 leukemic patients aged from 2 to 17 years at pediatric department, National Cancer Institute (NCI), Cairo University.  Anthropometric parameters, such as body weight and height were measured. Albumin level was measured as the biochemical marker for malnutrition. Malnutrition definition of every single parameter was done based on the American Society for Parenteral and Enteral Nutrition (ASPEN).  An overall malnutrition definition was based on St. Jude Children’s Research Hospital risk criteria. Socioeconomic status was determined by Al Shakhs familial socioeconomic status scale (SES) for hospitalized patients. Results: The presence of malnutrition at diagnosis differs depending upon the measurement used. It was 25.7% among children ≤10^th weight percentile and 30.6% among those ≤10^th height percentile. Hypo-albuminemia was found in 9.4% of children. At diagnosis, according to St. Jude Children’s Research Hospital risk criteria, about 26.7% were severely depleted. By the end of induction 35.2% had severe malnutrition at the final examination. There was no correlation between socioeconomic status and nutritional measurement parameters (p>0.05). Weak correlation between SES and albumin (r=0.29, p=0.039) was found. Conclusion: Malnutrition is not infrequent in pediatric leukemia patients at diagnosis and the percentage of severely depleted children increased by the end of induction therapy. SES is not correlated to malnutrition status during induction therapy.