scholarly journals Trends in age- and sex-adjusted body mass index and the prevalence of malnutrition in children with cancer over 42 months after diagnosis: a single-center cohort study

2019 ◽  
Vol 179 (1) ◽  
pp. 91-98
Author(s):  
Henri Aarnivala ◽  
Tytti Pokka ◽  
Riina Soininen ◽  
Merja Möttönen ◽  
Arja Harila-Saari ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Solid Tumors ◽  
Body Mass ◽  
Pediatric Cancer ◽  
Drug Toxicity ◽  
Myeloid Leukemia ◽  
Pediatric Cancer Patients ◽  
Age And Sex

Abstract The adequate nutritional status of pediatric cancer patients is particularly important to enable them to cope with the demands of the disease and its treatment and to maintain normal growth. Malnutrition and obesity have both been associated with reduced survival and increased drug toxicity. We investigated trends in the age- and sex-adjusted body mass index (ISO-BMI) and the prevalence of malnutrition in a Finnish cohort of 139 consecutive children receiving chemotherapy for cancer, with a follow-up period of 42 months after diagnosis. In total, 28% (39/139) of the patients experienced malnutrition (ISO-BMI < 17 or > 10% weight loss), and 12% (16/139) had a nasogastric tube or underwent gastrostomy. Patients with acute or chronic myeloid leukemia (5/10), central nervous system (CNS) tumors (5/13), or solid tumors (13/31) most frequently suffered from malnutrition. There was a significant increase in the ISO-BMI of patients with acute lymphoblastic leukemia (ALL) (+ 2.1 kg/m2) and lymphomas (+ 2.4 kg/m2) during the first 6 months, and the ISO-BMI of patients with ALL remained higher at 42 months compared to baseline (+ 1.9 kg/m2). Conclusion: The cumulative incidence of malnutrition in Finnish pediatric cancer patients is comparable to that reported in other populations. The nutritional status of patients with acute myeloid leukemia, CNS tumors, or solid tumors should be monitored with extra care to facilitate early intervention in the case of impending malnutrition.What is known:• Both malnutrition and obesity are associated with reduced survival and increased drug toxicity in pediatric cancer patients.What is new:• Overall, 28 % of Finnish children receiving chemotherapy for cancer suffer from malnutrition during the first 42 months following the initial cancer diagnosis. • ISO-BMI curves from initial diagnosis to 42 months after diagnosis are provided for patients with different types of cancer.

scholarly journals The Nutritional Status Sensitivity of the Assessment of Nutritional Status Based on Mini Nutritional Assessment (MNA) Was Compared with Patient-Generated Subjective Global Assessment (PG-SGA) in Cancer Patients Undergoing Chemotherapy in RSUP Dr Wahidin Sudirohusoda Makassar

2020 ◽  
Vol 4 (2) ◽  
pp. 76
Author(s):  
Khoirul Anam ◽  
Takdir Tahir ◽  
Ilkafah Ilkafah
Keyword(s):  
Body Mass Index ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Body Mass ◽  
Global Assessment ◽  
Nutritional Assessment ◽  
Subcutaneous Fat ◽  
Mini Nutritional Assessment ◽  
Subjective Global Assessment ◽  
Cross Sectional

Background: Chemotherapy is highly recommended for cancer treatment, however can cause some side effects such as nausea and vomiting. This will affect food intake and nutritional status in cancer patients who undergo chemotherapy. Aim: To describe nutritional status based on anthropometry Body Mass Index (BMI), hemoglobin (Hb), Patient-Generated Subjective Global Assessment (PG-SGA) and Mini Nutritional Assessment (MNA) in cancer patients undergoing chemotherapy in RSUP. Dr. Wahidin sudirohusodo Makassar. Methode: This experiment uses a quantitative non-experimental research method with cross sectional approach on 1010 patients, nonprobability sampling with purposive sampling technique on 70 respondents, data collection with interview and observation techniques. Results: Nutritional status based on Body Mass Index (BMI) shows that 39 people (55.7%) had normal BMI values. About 37 people (52.9%) had good / normal nutritional status based on Patient-Generated Subjective Global Assessment (PG-SGA)  while Mini Nutritional Assessment (MNA) reveals 100% of respondents experienced nutritional status problems. Conclusion: Mini Nutritional Assessment (MNA) is the best tool to identify nutritional status of cancer patients that undergo chemotherapy since this instrument is very sensitive and practical. Patient-Generated Subjective Global Assessment (PG-SGA) is good to assess nutritional status in subject who have lost weight drastically and shows signs of subcutaneous fat loss and muscle mass loss. Keyword: Cancer, chemotherapy, body mass index (BMI), Patient-Generated Subjective Global Assessment (PG-SGA), Mini Nutritional Assessment (MNA).

Prospective agnostic germline testing in pediatric cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1589-1589
Author(s):  
Elise Fiala ◽  
Jennifer Kennedy ◽  
Yelena Kemel ◽  
Audrey Mauguen ◽  
Diana Mandelker ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Solid Tumors ◽  
Pediatric Cancer ◽  
Spinal Tumors ◽  
Cancer History ◽  
Pediatric Solid Tumors ◽  
Pediatric Cancer Patients ◽  
High Penetrance ◽  
Tumor Types ◽  
Dominant Genes

1589 Background: We report our large cohort of pediatric cancer patients undergoing prospective agnostic germline sequencing. Our dataset is a significant addition to the 1,573 children reported to date who have undergone agnostic germline sequencing in previous large sequencing studies, each with ascertainment bias. Methods: 676 patients with pediatric solid tumors underwent matched tumor-normal targeted DNA sequencing from July 2015 to February 2020. At least 76 genes associated with cancer predisposition were analyzed in the germline, and variants were classified per American College of Medical Genetics guidelines. Pathogenic and likely pathogenic (P/LP) variants were reported to patients/families, who were offered genetic counseling and cascade testing with screening recommendations and referral to a surveillance clinic as appropriate. Results: One or more P/LP variants were found in 17% (115/676) of individuals when including low, moderate and high penetrance mutations in recessive and dominant genes, or 12% (81/676) when including moderate and high penetrance mutations in dominant genes. P/LP variants were detected in 40% (21/53) of patients with retinoblastomas, 8% (13/161) with neuroblastomas/ganglioneuroblastomas, 13% (14/112) with brain/spinal tumors, 8% (20/245) with sarcomas, and 12% (13/105) with other solid tumors. The most frequent mutations were in RB1 (n = 28) and TP53 (n = 8) in patients with associated tumors. Of patients with moderate/high penetrance mutations, 30% (24/81) had unexpected tumor types, with potential therapeutic relevance in 58% (14/24) including BRCA1 n = 2, BRCA2 n = 3, RAD51D n = 1, ATM n = 1 MLH1 n = 1, MSH2 n = 1, MSH6 n = 1, PMS2 n = 3, and SUFU n = 1. Two patients received immunotherapy based on their germline finding. Conclusions: P/LP germline variants are frequently present in patients with pediatric cancer. We are contributing significantly to the cohort size of agnostic sequencing in pediatric cancers. Our experience is similar to other studies with a ~12% detection rate of moderate and high penetrance mutations. Moderate/high penetrance mutations were concordant with the patient’s cancer history in 70% of cases, higher than previously reported, likely due to an enrichment of retinoblastoma. While many mutations are identified in patients with associated tumor types, a large proportion of mutations are unexpected based on the patient’s history. Clinical actionability of these findings may include screening, risk reduction, family planning, and increasingly targeted therapies.

Physical Activity in Pediatric Cancer patients with solid tumors (PAPEC): Trial rationale and design

2013 ◽  
Vol 36 (1) ◽  
pp. 106-115 ◽  
Author(s):  
Luisa Soares-Miranda ◽  
Carmen Fiuza-Luces ◽  
Alvaro Lassaletta ◽  
Elena Santana-Sosa ◽  
Julio R. Padilla ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cancer Patients ◽  
Solid Tumors ◽  
Pediatric Cancer ◽  
Pediatric Cancer Patients

Dexrazoxane exposure and risk of secondary acute myeloid leukemia in pediatric cancer patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1504-1504
Author(s):  
Dana Marie Walker ◽  
Yimei Li ◽  
Yuan-Shung Huang ◽  
Alix Eden Seif ◽  
Marko Kavcic ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Myeloid Leukemia ◽  
Administrative Database ◽  
Secondary Aml ◽  
Secondary Acute Myeloid Leukemia ◽  
Increased Risk ◽  
Pediatric Cancer Patients ◽  
Acute Myeloid

1504 Background: Dexrazoxane (DXZ) is an effective cardioprotectant in children with leukemia and solid tumors. However, the potential risk of secondary acute myeloid leukemia (AML) limits DXZ use. We compared the incidence of secondary AML in pediatric cancer patients with and without DXZ exposure to estimate the risk of DXZ-associated secondary AML. Methods: We conducted a retrospective cohort study of anthracycline exposed pediatric cancer patients (excluding de novo AML) hospitalized from January 1999 to March 2011 in 43 freestanding children’s hospitals in the Pediatric Health Information System (PHIS) database. Secondary AML was defined as an ICD9 code for AML that occurred at least 90 days after first anthracycline exposure. Proportions of patients with secondary AML were compared between patients with and without an exposure to DXZ after the initial anthracycline exposure. Results: During the study period of interest, 15,532 pediatric cancer patients were exposed to anthracycline, of which 1404 (9.04%) subsequently received DXZ. Secondary AML was identified in 235 (1.51%) patients. Patients ≥ 10 years of age, black patients, patients in New England and the Midatlantic regions, and those with bone tumors were significantly more likely to have received DXZ. The unadjusted incidence of secondary AML in the DXZ exposed and unexposed patients did not differ significantly (1.21% v. 1.54%, p=0.3308). After adjusting for these variations in demographics, the incidence of secondary AML still did not significantly differ between DXZ exposed and unexposed patients (p=0.6224). Conclusions: Our findings suggest that DXZ exposure does not lead to an increased risk of secondary AML in children. These data are important given the conflicting results from individual clinical trials about the risk of DXZ-associated secondary AML. While subject to well-known limitations of administrative database analyses, these data represent the largest cohort of DXZ exposed patients with available data on the occurrence of secondary AML. Additional multivariate analyses of chemotherapeutic covariates and time to secondary AML are ongoing.

Circulating myeloid-derived suppressor cells in pediatric solid tumor patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9565-9565
Author(s):  
John M. Goldberg ◽  
Abdel-Aziz Zidan ◽  
Rabia Siddiqi ◽  
Myriam Zayas ◽  
Camille D. Brown ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Solid Tumors ◽  
Pediatric Cancer ◽  
Suppressor Cells ◽  
Prognostic Indicators ◽  
Healthy Children ◽  
Myeloid Derived Suppressor Cells ◽  
Children With Cancer ◽  
Pediatric Cancer Patients ◽  
The Mean

9565 Background: Cure rates have reached a plateau for many pediatric solid tumors. Identifying new therapeutic targets, biomarkers of response and prognostic indicators should improve clinical outcomes. Accumulation of myeloid derived suppressor cells (MDSCs) is an important mechanism of tumor mediated immune evasion. Increased levels of MDSCs in adult cancer patients correlate with a worse prognosis, and decrease in levels with treatment is associated with benefit. Little is known about MDSCs in childhood, or in children with cancer. This pilot measured levels of MDSCs in pediatric patients with cancer and healthy children. Methods: We enrolled subjects using an Institutional Review Board approved protocol after obtaining informed consent. Blood was obtained from 14 children with newly diagnosed or recurrent solid tumors at start of therapy. In 10 of these patients, levels were also drawn after therapy. Blood was obtained once from 6 healthy children in a primary care office. Samples were obtained concurrently with complete blood counts. MDSCs were measured on fresh whole blood and were defined as Lin-1+/HLADR-/CD 33+/CD11b+/ by flow. Total MDSC numbers were then calculated. Results: The mean total number of MDSCs was 596 cells/ul at diagnosis for the 14 children with cancer and 170 cells/ul for the 6 healthy children (t(18) = 3.02, p = .0073). For the 10 children with cancer who had repeat values measured after treatment, MDSCs decreased in 4 and increased in 6. The mean initial MDSC count for these children was 494 cells/ul, and the mean post treatment count was 1716 cells/ul (t(9) = 1.81, p = .1036). Larger change scores tended to be associated with children treated with alkylator therapy followed by G-CSF. The results for percent MDSC in white cells mirrored those of total number. Conclusions: Circulating MDSCs were higher in pediatric cancer patients than healthy controls. Cancer treatment did not reliably reduce MDSC levels. After some treatments, the levels increased, potentially increasing immune tolerance. Further research is needed to determine if circulating MDSCs are a reliable predictive or prognostic marker in pediatric cancer, and whether they represent a potential target for therapeutic intervention.

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