Prevalence of vitamin D deficiency in childhood acute lymphoblastic leukemia and its association with adverse outcomes during induction phase of treatment

Aim. To analyze the common cause of death in childhood acute lymphoblastic leukemia patients. Methods and Materials. A retrospective descriptive study on children with acute lymphoblastic leukemia who died at Hue Central Hospital between 2008 and 2018. All the patients were treated with the same protocol of modified Children’s Cancer Group 1882 and 1881. Results. A total of 238 children with acute lymphoblastic leukemia who were cared for at our center were enrolled. Of these, there were 74 deaths. Among the death group, the male-to-female ratio was 2.7:1. Twenty-six (35.1%) occurred in maintenance phase, 18 (24.3%) occurred in induction phase, and 9 (12.2%) occurred in delayed intensification. Infection was responsible for deaths in 32 of 74 (43.2%) cases. Pseudomonas aeruginosa was found in 3 of 32 infected cases (9.4%) and resistance to almost all antibiotics in our hospital. Relapse, abandonment, and bleeding were documented in 20 (27.0%), 7 (9.5%), and 6 (8.1%) cases, respectively. Twenty-seven (84.3%) patients had absolute neutrophil count <500/µL. Of 32 infectious deaths, pneumonia occurred in 40.6%. Regarding 20 relapse death, bone marrow was the major site of relapse and it occurred in 13 (65%) cases. And there were 65% patients with very early relapse. Conclusions. Infection is the major cause of mortality in acute lymphoblastic leukemia patients in our study. To improve outcome, we should improve supportive care, especially prevention and control infection.

Download Full-text

Cardiovascular dysfunction and vitamin D status in childhood acute lymphoblastic leukemia survivors

World Journal of Pediatrics ◽

10.1007/s12519-019-00258-y ◽

2019 ◽

Vol 15 (5) ◽

pp. 465-470 ◽

Cited By ~ 1

Author(s):

Paola Muggeo ◽

Vito Michele Rosario Muggeo ◽

Paola Giordano ◽

Maurizio Delvecchio ◽

Maria Altomare ◽

...

Keyword(s):

Vitamin D ◽

Acute Lymphoblastic Leukemia ◽

Lymphoblastic Leukemia ◽

Childhood Acute Lymphoblastic Leukemia ◽

Vitamin D Status ◽

Cardiovascular Dysfunction

Download Full-text

Vitamin D nutritional status and bone turnover markers in childhood acute lymphoblastic leukemia survivors: A PETALE study

Clinical Nutrition ◽

10.1016/j.clnu.2018.02.006 ◽

2019 ◽

Vol 38 (2) ◽

pp. 912-919 ◽

Cited By ~ 3

Author(s):

E. Delvin ◽

N. Alos ◽

F. Rauch ◽

V. Marcil ◽

S. Morel ◽

...

Keyword(s):

Vitamin D ◽

Acute Lymphoblastic Leukemia ◽

Nutritional Status ◽

Bone Turnover ◽

Bone Turnover Markers ◽

Lymphoblastic Leukemia ◽

Childhood Acute Lymphoblastic Leukemia ◽

Turnover Markers

Download Full-text

Blood glucose level during induction phase chemotherapy in childhood acute lymphoblastic leukemia

Paediatrica Indonesiana ◽

10.14238/pi60.4.2020.197-2 ◽

2020 ◽

Vol 60 (4) ◽

pp. 197-2

Author(s):

Nunki Andria ◽

Annang Giri Moelyo ◽

Muhammad Reza

Keyword(s):

Blood Glucose ◽

Acute Lymphoblastic Leukemia ◽

Nutritional Status ◽

Blood Glucose Level ◽

Glucose Level ◽

Side Effect ◽

Lymphoblastic Leukemia ◽

Childhood Acute Lymphoblastic Leukemia ◽

Induction Phase ◽

Remission Status

Background Steroids and L-asparaginase (L-Asp) are agents used in induction phase chemotherapy for childhood acute lymphoblastic leukemia (ALL). Both agents are often reported to have the side effect of hyperglycemia, and native L-Asp is also reported to cause hypoglycemia. In ALL patients, hyperglycemic events during chemotherapy can cause lower 5-year overall and relapse-free survival. Objective To investigate the incidence of abnormal blood glucose level (BG) as the side effect of prednisone and L-Asp during induction phase chemotherapy, its predisposing factors, and its effect on remission status. Methods This cohort prospective study was conducted in 36 children aged 1-18 years who were newly diagnosed with childhood ALL at Dr. Moewardi Hospital, Surakarta, Central Java. Subjects’ nutritional status consist of wellnourished and undernourishment. Subjects underwent BG monitoring. At the end of induction phase chemotherapy, subjects underwent bone marrow puncture (BMP) evaluation to assess their response to chemotherapy and the effect of abnormal BG on remission status. Results Hypoglycemia, a combination of hypoglycemia and hyperglycemia, hyperglycemia, as well as euglycemia, were experienced by 9, 7, 6, and 14 subjects, respectively. Nutritional status was found to be a significant risk factor for abnormal BG. There was no significant difference in remission status at the end of induction phase chemotherapy between the euglycemic group and abnormal BG groups (P=0.533). Conclusion Abnormal BG during induction phase chemotherapy did not affect remission status at the end of induction phase. Undernourishment is also found to be a predisposing factor in abnormal BG.

Download Full-text

Correlative Study Between Nutritional Status and Remission Outcome in Childhood Acute Lymphoblastic Leukemia in Dr. Soetomo General Hospital Surabaya

Biomolecular and Health Science Journal ◽

10.20473/bhsj.v2i1.12723 ◽

2019 ◽

Vol 2 (1) ◽

pp. 27

Author(s):

Asma' Athifah ◽

Siti Nurul Hidayati ◽

Sulistiawati Sulistiawati

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Nutritional Status ◽

General Hospital ◽

Risk Group ◽

Lymphoblastic Leukemia ◽

High Risk Group ◽

Childhood Acute Lymphoblastic Leukemia ◽

Induction Phase ◽

Cross Sectional ◽

Term Survival

Introduction: The most common malignancy that is diagnosed in children is acute lymphoblastic leukemia. Undernourished children tend to have poorer long term survival. This descriptive analytic study is aimed towards analyzing the correlation between nutritional status at diagnosis and outcomes of induction phase therapy in childhood acute lymphoblastic leukemia at the Department of Pediatrics Dr. Soetomo General Hospital Surabaya in 2014.Methods: A cross-sectional method using the medical records of patients is used in this study. The nutritional statuses of patients are calculated using weight for length/height trough curves of WHO 2006 or CDC 2000.Results: The results show that from 45 children diagnosed with ALL, 53% are of the age ≤ 5 years old, with 58% males and 42% females. 13% of the patients are in the high risk group and 87% are in the standard risk group. Nutritional statuses of patients are 2% of them obese experienced remission after induction phase therapy, 56% normal with 80% of them experienced remission. 40% underweight with 89% of them experienced remission and 11% not experienced remission, 2% malnutrition and experienced remission. There is no correlation between the nutritional status of children with acute lymphoblastic leukemia with the outcome of induction phase (p = 0.798).Conclusion: In conclusion, there is no correlation between nutritional status and remission outcome of patients with ALL in the induction phase of therapy. However, high percentage of underweight patients shows nutrition needs special attention to improve therapy outcomes.

Download Full-text