Impact of Nutrition on Treatment Outcome in Acute Lymphoblastic Leukaemia of Childhood in Developing Country

Abstract 4744

Malnutrition is a major problem in children with cancer. All conventional modalities of anti cancer therapy interfere with normal nutrition. In this study we retrospectively analyzed 331 children of Acute Lymphoblastic Leukaemia (ALL) being intensively treated by National cancer Institute protocol (MCP 841) during period from August, 2000 to December, 2010 in a tertiary cancer institute of the country. Our aim was to determine the nutritional status of children with ALL at diagnosis and to study the influence of nutrition on complete remission, disease free survival (DFS) and toxicity of chemotherapy. The variables studied were height for age, weight for age and serum albumin levels. The height for age and the weight for age were taken as normal if they were between 3^rd and 97^th percentile curve of the growth chart as recommended by the Indian Council of Medical Research (ICMR). The albumin level was considered normal if the value was equal to or more than 3 gm%. It was seen that 16.9% children were low weight for age and 10.3% were of low height for age at diagnosis. Low weight for age (p value <0.01) and low albumin (p-value <0.005) were significant in DFS.

We conclude that malnutrition is having much impact on prognosis of ALL in developing countries like ours. The major nutrition indicators are height for age, weight for age and serum albumin. The patients with malnutrition have less DFS duration, more chances of relapse and more toxicity during therapy as compared to well nourished children.