Malnutrition in childhood cancer patients: Magnitude, key indicators and outcome
Harshita Gupta, Gitika Pant, Nishant Verma
Abstract
Background and Objectives: Malnutrition in Pediatric oncology is an impediment for treating physicians. Diagnosing and classifying malnutrition in Pediatric oncology is a challenging task as weight/height-based parameters are not definitive in cancer settings. The study was conducted with the aim to identify the prevalence of malnutrition among cancer patients, comparing various nutritional indicators defining and classifying malnutrition in various age groups and assessing overall survival of these patients. Methods: All patients less than 18 years diagnosed with cancer between January 2016 to December 2018 were included in the study. The age, sex and anthropometric parameters by weight, length/ height, mid upper arm circumference (MUAC) of every child was taken and WHO growth chart, Indian Academy of Pediatrics (IAP) growth charts and MUAC charts were used accordingly. Based on these charts children were diagnosed and degree of malnutrition was determined. Also, various indicators defining malnutrition were sought and their overall outcomes were compared. Results: Total 962 patients were registered and overall incidence of acute malnutrition was 69.9% when MUAC was taken as nutritional indicator. Chronic malnutrition was found in 43.9%. There was no difference in the incidence of malnutrition in solid versus hematolymphoid (HML) malignancies and the same was reflected in overall survival (OS) also. OS was not different for malnourished versus normally nourished children. Conclusion: We had a higher incidence of malnutrition when compared to previous studies and this fortunately didn’t reflect in terms of higher mortality in malnourished patients. A dedicated dietary team could be one of the many reasons. MUAC parameter was probably more reliable than weight/height-based parameters in detecting malnutrition in pediatric oncology in children less than 5 years with solid tumours. For children more than 5 years, age appropriate MUAC might be used in resource constraint setting.