Abstract:
Undernutrition in children with cancer is associated with complications during cancer therapy. The study objective was to determine the association between specific anthropometric parameters and short-term chemotherapy-related complications and mortality. This was a hospital-based, prospective cohort study of children, age ≤12 years, with a new cancer diagnosis at the Paediatric Oncology Unit, Korle Bu Teaching Hospital, Ghana. Socio-demographic information, cancer characteristics and anthropometric measurements were obtained at enrolment. Participants were followed up for twelve weeks from commencement of chemotherapy and selected treatment-related complications such as anaemia and thrombocytopenia requiring transfusions, prolonged neutropenia resulting in treatment delays, febrile neutropenia, mucositis and death were recorded. A total of 133 participants were recruited with a median age of 4.5 years. Eighty-one (60.9%) were diagnosed with solid tumours, 31 (23.3%) had leukaemias and 21 (15.8%) had lymphomas. Of the anthropometric parameters assessed, only arm anthropometry using upper arm muscle area (UAMA) and mid-upper arm circumference (MUAC) were associated with complications. Participants with wasting were more likely to develop anaemia and mucositis. However, the incidence of prolonged neutropenia was significantly higher among participants with average UAMA (p = 0.043) and low average UAMA (p = 0.049) compared to those with low UAMA. Risk of neutropenia was also significantly less among those with wasting by MUAC compared to those well-nourished (p = 0.045). Twenty-three participants (17.3%) died with a greater proportion (11/44; 25%) occurring in those who were wasted using MUAC. These findings underscore the need for nutritional surveillance at diagnosis and during chemotherapy, particularly where co-morbid disease is prevalent.
摘要:
癌症儿童营养不良与癌症治疗期间的并发症有关。研究目的是确定特定人体测量参数与短期化疗相关并发症和死亡率之间的关系。这是一家医院,儿童前瞻性队列研究,年龄≤12岁,儿科肿瘤科的新癌症诊断结果,KorleBu教学医院,加纳。社会人口统计信息,在登记时获得了癌症特征和人体测量学测量结果.参与者在化疗开始后随访12周,并选择治疗相关并发症,如贫血和血小板减少症,需要输血。长时间的中性粒细胞减少导致治疗延迟,发热性中性粒细胞减少症,记录黏膜炎和死亡。总共招募了133名参与者,中位年龄为4.5岁。八十一人(60.9%)被诊断为实体瘤,31(23.3%)患有白血病,21(15.8%)患有淋巴瘤。在评估的人体测量参数中,仅使用上臂肌肉面积(UAMA)和中上臂围(MUAC)的上臂人体测量法与并发症相关.消瘦的参与者更有可能发生贫血和粘膜炎。然而,与低UAMA组相比,平均UAMA组(p=0.043)和低平均UAMA组(p=0.049)长期中性粒细胞减少症的发生率明显较高.与营养良好的患者相比,MUAC消瘦的患者中性粒细胞减少症的风险也显着降低(p=0.045)。23名参与者(17.3%)死亡,其中使用MUAC浪费的人死亡比例更高(11/44;25%)。这些发现强调了在诊断和化疗期间进行营养监测的必要性,特别是在共病流行的地方。