Association between nutritional status and outcome of childhood acute lymphoblastic leukemia treated with Wijaya Kusuma Protocol
Keywords:
acute lymphoblastic leukemia, nutritional status, relapse, death
Abstract
Background Acute lymphoblastic leukemia (ALL) is the mostcommon malignancy in childhood. Malnutrition in malignancy
patients including ALL is one of major problems. This condition
is found at the time of diagnosis as a result of the disease itself or
after, chemotherapy or radiation. Many studies have been
conducted to determine the relationship between nutritional state
and outcome of childhood ALL patients but the result was still
controversial.
Objective To determine relative risk of death and relapse in
childhood standard-risk ALL who received therapy using Wijaya
Kusuma protocol.
Methods This was a retrospective cohort study. Newly-diagnosed
patients since May 1999-December 2004 were taken for this study.
Body mass index was used to measure nutritional status for >2
years old children, and weight-for-height was used for those of
=2 years old. Data was obtained from Yogyakarta Pediatric Cancer
Registry Dr. Sardjito Hospital. Chi-squared test was used to analyze
the proportion difference and risk relative was used to determine
risk for death and relapse.
Results One-hundred and forty five patients included in this study.
There was no association between nutritional state and relapse
(RR 1.1, 95% CI 0.76;1.61). Logistic regression analysis showed
that there was association between nutritional state and death
(RR 2.34, 95% CI 1.01;5.45). Sepsis and relapse have contribution
to death as well (RR 6.75, 95% CI 2.9;15.4 and RR 3.2, 95% CI
1. 3;8.08 respectively).
Conclusion Nutritional status is not associatiated with relapse
but is associated with death of ALL children.
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year age-specific rates by histological type. Cancer 1995;75:
2186–95.
2. Friedmann AM, Weinstein HJ. The Role of Prognostic
Feature in Treatment of Childhood Acute Lymphoblastic
Leukemia. The Oncologist 2000;3:321-8.
3. Ries LA, Kosary CL, Hankey BF. SEER Cancer Statistics
Review, 1973-1996. Bethesda, Md: National Cancer
Institute.
4. Mulatsih S, Sumadiono, Sutaryo, Purwanto. The Result of
Treating Children’s Acute Lymphoblastic Leukemia (ALL)
in Dr. Sardjito Hospital With WK-ALL Protocol 1999 – 2002.
Bulletin Ilmu Kesehatan Anak 2005;17:808-19.
5. Yu LC. Nutrition and childhood malignancies. In: Suskin
RM, Lewinter-Suskind L, editors. Textbook of pediatric
nutrition. 2 nd ed. New York: Raven Press Ltd;1993. p. 417–
24.
6. Viana M, Murao M, Ramos G. Malnutrition as a prognostic
factor in lymphoblastic leukemia: a multivariate analysis.
Arch Dis Child 1994;71:304-10.
7. Mejia-Arangure JM, Fajardo-Gutierrez A, Reyes-Ruiz NI,
Bernaldez-Rios R, Mejia-Dominguez AM, Navarrete-
Navarro S, et al. Malnutrition in childhood lymphoblastic
leukemia: a predictor of early mortality during the induction-
to-remission phase of the treatment. Arch Med Res
1999;30:150-3.
8. Lobato-Mendizabal E, Lopez-Martinez B, Ruiz-Arguelles GJ.
A critical review of the prognostic value of the nutritional
status at diagnosis in the outcome of therapy of children with
acute lymphoblastic leukemia. Rev Invest Clin 2003;55:31-
5.
9. Weir J, Reilly JJ, McColl JH, Gibson BE. No evidence for an
effect of nutritional status at diagnosis on prognosis in
children with acute lymphoblastic leukemia. J Pediatr
Hematol Oncol 1998;20:534-8.
10. Kahn R, Sheikh MH, Inthekab K. Does weight for age have
prognostic significance in children with acute lymphoblastic
leukemia? Pak J Med Sci 2006;2:167–70.
11. Supriyadi E. Sutaryo. Status Gizi sebagai faktor prognostik
pada leukemia limfoblastik Akut di RSUP dr. Sardjito [Tesis].
Yogyakarta: Universitas Gadjah Mada; 2001.
12. Halton JM, Atkinson SA, Barr RD. Growth and Body
Composition in Response to Chemotherapy in Children wit
Acute Lymphoblastic Leukemia. Int J Cancer Supple
1998;11:81–4.
13. Pearce JM, Sils RH. Childhood Leukemia. Pediatric Review
2005;26:96-104.
14. Smith M, Arthur D, Camitta B. Uniform approach to risk
classification and treatment assignment for children with
acute lymphoblastic leukemia. J Clin Oncol 1996;14:18-
24.
Published
2008-02-29
How to Cite
1.
Herintya F, Mulatsih S, Prawirohartono E. Association between nutritional status and outcome of childhood acute lymphoblastic leukemia treated with Wijaya Kusuma Protocol. PI [Internet]. 29Feb.2008 [cited 25Apr.2024];48(1):28-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/462
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Received 2016-09-05
Accepted 2016-09-05
Published 2008-02-29
Accepted 2016-09-05
Published 2008-02-29
