Purpose:
To investigate the relationship between
survival and
malnutrition at the
time of
diagnosis among
children treated for
cancer in two
developing countries.
Patients and
Methods:
We studied 443
children treated for
cancer between 1995 and 1998 at two centers in San Salvador,
El Salvador, and Recife,
Brazil. Median age at
diagnosis was 4.9 years; 283
children had
leukemia and 260 had solid
tumors. Z scores were calculated for weight for age (WAZ), height for age (HAZ), and weight for height (WHZ) at
diagnosis. Z scores < -2 indicated
malnutrition.
Patients were also stratified by low-
risk disease (solid
tumors stage I, stage II, or localized;
acute lymphocytic leukemia WBC count < 25,000/uL, negative CNS, no mediastinal mass and age > 1 and < 10 years) and high-
risk disease (all other
patients, including those with acute or
chronic myelocytic leukemia).
Results:
Z scores indicated
malnutrition in 15.7 por cento (WHZ), 23.5 por cento (WAZ), and 22.8 por cento (HAZ) of
patients. Z score was not significantly related to overall
survival rates, to
survival rates analyzed by type of
malignancy or
risk status, or to
survival rates at the end of the first month of
treatment.
Conclusions:
We found no relationship between
nutritional status and
survival in these
patients. This implies that
future protocols for use in
developing countries can be designed to provide optimal
treatment intensity despite the high
incidence of
malnutrition