Malnutrition as a predictor of adverse outcomes of febrile neutropenia in children with acute lymphoblastic leukemia during induction phase chemotherapy

Farzana Alam Mou; M. Arafatara Khatun; Umme Nusrat Ara; Tania Sultana; Sharmin Akhter; Tapas Chowdhury; Chowdhury Yakub Jamal; S. M. Rezanur Rahman; Zamil Ahmed Manik

doi:10.18203/2349-3291.ijcp20233956

Authors

Farzana Alam Mou Department of Hematology and Stem Cell Transplant, Evercare Hospital, Dhaka, Bangladesh
M. Arafatara Khatun National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
Umme Nusrat Ara Department of Pediatric Hematology and Oncology, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh
Tania Sultana Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Sharmin Akhter Department of Hematology and Bone Marrow Transplantation, Asgar Ali Hospital, Dhaka, Bangladesh
Tapas Chowdhury Department of Pediatrics and Neonatology, Bangladesh Specialized Hospital, Dhaka, Bangladesh
Chowdhury Yakub Jamal Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
S. M. Rezanur Rahman Department of Paediatric Haematology and Oncology, Dhaka Medical College Hospital, Dhaka, Bangladesh
Zamil Ahmed Manik Department of Paediatric Hematology and Oncology, Institute of Child and Mother Health, Matuail, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20233956

Keywords:

Malnutrition, FN, ALL, Induction, Chemotherapy

Abstract

Background: Adequate nutrition is an important concern in children with leukemia. Malnutrition impairs immune function, leading to increased incidence of infection, poor quality of life, as well as death. Febrile neutropenia (FN) has a high prevalence in children with acute lymphoblastic leukemia (ALL) and a poor outcome as well.

Methods: This prospective observational study was done in the department of pediatrics hematology and oncology (PHO), BSMMU, from January 2021 to October 2021. A total of 60 patients of ALL were selected purposively. Patients were evaluated by taking anthropometric parameters before getting chemotherapy and were prospectively followed up for the development and outcome of FN until recovery. Statistical analysis was performed by using SPSS (Statistical package for the social sciences) for Windows version 26.0.

Result: Analysis of nutritional status as a risk factor for FN based on anthropometric indices, was found statistically significant for, weight for height (≤5 years) p=0.036, OR=0.24 (95% CI= 0.06-0.958), weight for age p=0.006, OR=0.23 (95% CI=0.07-0.67), but for BMI for age (>5 years) p=0.28, OD=0.28 (95% CI=0.02-3.19), and height for age p=0.513, OD=0.66 (95% CI=0.18-2.33) no statistically significant value was found. In this study, we found mortality rate was 15%. The mortality rate was significantly worse (27.3%) for patients who were malnourished at diagnosis as compared to those who were well nourished (7.9%) at diagnosis.

Conclusions: FN and its complications are more common in malnourished children with ALL. Malnutrition is associated with adverse outcomes of FN in children with ALL.

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