Effective nutritional intervention improves the health-related quality of life (HRQL) of undernourished children with cancer: results of a randomized, controlled phase 3 trial.

Purpose: The association of nutritional intervention and health-related quality of life (HRQL) was examined in children with cancer.

Methods: Undernourished children with cancer (N = 260) were randomized 1:1 to standard nutritional therapy (SNT) or SNT + Ready to Use Therapeutic Food (RUTF). HRQL was assessed using the Health Utilities Index® (HUI) at study entry and 6 weeks later.

Southern European Prospective Investigation Into Childhood Cancer and Nutrition (EPICkids): Study design and protocol.

The survival rates for children with cancer have increased appreciably over the last few decades; however, childhood cancer survivors continue to suffer from long-lasting sequelae. Studies have demonstrated that the presence of malnutrition, over- and under-nutrition, at diagnosis or the duration of malnutrition during treatment is associated with increased toxicity, infection, and inferior survival. Dietary habits, along with behavioral and socioeconomic status, are known factors that lead to obesity or undernutrition and can affect the prognosis and quality of life of children with cancer.

Consensus recommendations for the nutritional management of children with cancer in limited resource settings: a report from the International Initiative for Pediatrics and Nutrition.

Introduction: Malnutrition (under- and over-nutrition) is a critical challenge in pediatric oncology, particularly in low- and middle-income countries (LMIC), where supportive care resources are scarce. It negatively impacts treatment toxicity, survival rates, and quality of life. Despite the availability of broad guidelines, there is a lack of practical, context-adapted protocols for nutritional assessment and intervention in LMIC.

Prevalence of Chronic and Acute Malnutrition and Association With Overall Three-Year Survival in Newly Diagnosed Children With Cancer in South Africa.

Introduction: This study investigated the prevalence of malnutrition at childhood cancer diagnosis in South Africa and the association with 1-year post-diagnosis overall survival (OS).

Method: Nutritional status was prospectively assessed for newly diagnosed children with cancer. Chronic undernutrition was defined as two standard deviations (SDs) or more below zero for height/length-for-age (HAZ), and acute as underweight (weight-for-age [WAZ], and wasted as body mass index for age [BAZ] and mid-upper arm circumference for age [MUAC/A]).

Nutritional status, body composition and chemotherapy dosing in children and young people with cancer: a systematic review by the SIOP nutrition network.

Malnutrition (undernutrition or overweight/obesity) might significantly impact the pharmacokinetics and pharmacodynamics of antineoplastic drugs in children and adolescents (<21 years). A comprehensive systematic literature search was performed on MEDLINE (PubMed), EMBASE, Web of Science, Scopus, ProQuest, Cochrane Trials, and Cochrane Reviews. Databases were searched up to 30 September 2024.

Prevalence of undernutrition in children with cancer in low-income and middle-income countries: a systematic review.

Background: Undernutrition is linked to decreased survival in childhood cancer. However, its global impact remains unclear, and childhood cancer is not recognised as a high-risk factor in WHO nutrition guidelines. This systematic review quantifies the prevalence and clinical outcomes of undernutrition among children with cancer in low-income and middle-income countries (LMICs), highlighting the global burden and impact on children with cancer.

Body Mass Index, Physical Activity, and Subsequent Neoplasm Risk Among Childhood Cancer Survivors.

Importance: High body mass index (BMI) and low physical activity levels are risk factors for adult-onset cancers. Limited data exist on their relationship with subsequent neoplasms among childhood cancer survivors.

Objective: To evaluate associations between time-varying BMI/physical activity and subsequent neoplasm risk among childhood cancer survivors.

Overweight or Obesity and Outcomes in Children With Acute Lymphoblastic Leukemia.

Importance: There are conflicting data on the association of overweight or obesity with clinical outcomes in childhood acute lymphoblastic leukemia (ALL). The duration of exposure to overweight or obesity may be a better indicator of the risk of poorer outcomes.

Objective: To determine the association of the duration of overweight or obesity with treatment-related toxic effects, minimal residual disease, relapse, and survival in childhood ALL.

Use of food restrictions to prevent infections in paediatric patients with cancer and haematopoietic cell transplantation recipients: a systematic review and clinical practice guideline.

Background: Food restrictions during periods of neutropenia have been widely used in oncology settings to prevent infections. As there is a lack of clearly demonstrated effectiveness, this strategy is being increasingly questioned.

Methods: A multi-national panel of 23 individuals was convened to develop a clinical practice guideline (CPG) on the use of food restrictions to prevent infections in paediatric patients with cancer and haematopoietic cell transplantation (HCT) recipients.

Pharmacologic Management of Obesity in Neuro-Oncology: A Case Report.

Introduction: Brain tumors are the most common solid tumors in pediatric oncology. Advances in the treatment of childhood brain tumors have led to increased survival; however, treatment-related morbidity remains high. The risk of developing overweight/obesity or significant weight gain is commonly observed in children with a brain tumor often due to hypothalamic damage as a result of radiation therapy, surgery, or the tumor itself.

Implemented nutritional intervention algorithm in pediatric oncology compared to standard nutritional supportive care outcomes.

Aim: To implement a childhood cancer-specific nutritional algorithm adapted for the South African context for interventions at time-set intervals to evaluate differences in the nutritional status of newly diagnosed children with cancer.

Method: Children with newly diagnosed cancer were assessed for stunting, underweight, wasting, and moderate to severe malnutrition (MUAC < -2SD and < - 3 SD) between October 2018 and December 2020 in a longitudinal nutritional assessment study with monthly assessments. Two pediatric oncology units (POUs) served as the intervention group that implemented the nutritional algorithm-directed intervention and three other POUs formed the control group that implemented standard supportive nutritional care.

Genome-wide study identifies novel genes associated with bone toxicities in children with acute lymphoblastic leukaemia.

Bone toxicities are common among paediatric patients treated for acute lymphoblastic leukaemia (ALL) with potentially major negative impact on patients' quality of life. To identify the underlying genetic contributors, we conducted a genome-wide association study (GWAS) and a transcriptome-wide association study (TWAS) in 260 patients of European-descent from the DFCI 05-001 ALL trial, with validation in 101 patients of European-descent from the DFCI 11-001 ALL trial. We identified a significant association between rs844882 on chromosome 20 and bone toxicities in the DFCI 05-001 trial (p = 1.

Early Life Nutrition Factors and Risk of Acute Leukemia in Children: Systematic Review and Meta-Analysis.

Acute leukemia commonly occurs in young children with peak incidence at the age of 2-5 years. However, the etiology is still unclear and many preventable risk factors still deserve to be reviewed. The focus of this systematic review and meta-analysis is to summarize the evidence concerning early life nourishment (breastfeeding, early life diet), neonatal vitamin K administration and the risk of acute leukemia.

Sarcopenia in Children With Wilms Tumor: A Marker of Undernutrition Which May Impact Adversely on Clinical Outcomes.

The therapeutic approach to Wilms tumor (WT) is multidisciplinary and leads to significant patient impairment, increasing the risk of nutritional compromise and malnutrition. Children with cancer are vulnerable to sarcopenia which has been recognized as a negative impact of anticancer therapy. Recent studies have highlighted the reduction in the total psoas muscle area (TPMA) to be associated with a poor prognosis in many pediatric diseases, including cancer.

Improving the Quality of the Delivery of Nutritional Care Among Children Undergoing Treatment for Cancer in a Low- and Middle-Income Country.

Purpose: International twinning programs have been well-established between institutions in childhood cancer and have led to pediatric cancer units in low- and middle-income countries (LMICs) adopting multidisciplinary forms of care. To advance nutritional care in LMICs, the International Initiative for Pediatrics and Nutrition (IIPAN) provided the structural framework and personnel for the delivery of nutritional care. We describe the impact of a newly established nutrition program on the delivery of nutritional care and nutrition-related clinical outcomes in children and adolescents undergoing treatment for cancer in Nicaragua and Honduras.

Role of Maternal Diet in the Risk of Childhood Acute Leukemia: A Systematic Review and Meta-Analysis.

Many studies have investigated the etiology of acute leukemia, one of the most common types of cancer in children; however, there is a lack of clarity regarding preventable risk factors. This systematic review and meta-analysis aimed to summarize the current evidence regarding the role of maternal dietary factors in the development of childhood leukemia. All epidemiological studies published until July 2022 that evaluated maternal dietary risk factors for childhood acute leukemia were identified in two electronic databases (PubMed and Web of Science) without limits of publication year or language.

Prevalence of vitamin and iron deficiencies at cancer diagnosis at two pediatric oncology units in South Africa.

This study investigates the prevalence of vitamin and iron deficiencies at cancer diagnosis. Newly diagnosed children between October 2018 and December 2020 at two South African pediatric oncology units (POUs) were assessed for nutritional and micronutrient status (Vit A, Vit B12, Vit D, folate, and iron). A structured interview with caregivers provided information regarding hunger and poverty risks.

A systems approach points to a therapeutic role for retinoids in asparaginase-associated pancreatitis.

Among drug-induced adverse events, pancreatitis is life-threatening and results in substantial morbidity. A prototype example is the pancreatitis caused by asparaginase, a crucial drug used to treat acute lymphoblastic leukemia (ALL). Here, we used a systems approach to identify the factors affecting asparaginase-associated pancreatitis (AAP).

Current status of African pediatric oncology education efforts aligned with the Global Initiative for Childhood Cancer.

Education of the pediatric oncology workforce is an important pillar of the World Health Organization CureAll technical package. This is not only limited to healthcare workers, but all stakeholders in the childhood cancer management process. It includes governmental structures, academic institutions, parents and communities.

Survey of the use of traditional and complementary medicine among children with cancer at three hospitals in Cameroon.

Introduction: There is lack of diagnostic and treatment resources with variable access to childhood cancer treatment in low- and middle-income countries (LMIC), which may lead to subsequent poor survival. The primary aim of this study was to determine the prevalence and types of traditional and complementary medicine (T&CM) used in Cameroon. Secondarily, we explored determinants of T&CM use, associated costs, perceived benefits and harm, and disclosure of T&CM use to medical team.

Addition of arm anthropometry to body mass index for age, but not serum albumin, improves the accuracy of the nutritional assessment in severely and moderately malnourished children with cancer.

Arm anthropometry is a more sensitive measure of nutritional status than body mass index for age (BMI) in children with cancer, but the added utility of serum albumin remains uncertain. Concordance was determined among four forms of classifying nutritional status in a cohort of undernourished children with cancer: method 1: BMI-for-age Z score; method 2: method 1 + mid-upper arm circumference (MUAC) percentile; method 3: method 2 + triceps skinfold thickness (TSFT) percentile; and method 4: method 3 + serum albumin. Concordance was highest between methods 2 and 3, followed closely by 3 and 4, indicating that addition of arm anthropometry, but not serum albumin, to BMI increased the sensitivity of baseline nutritional assessment.

Malnutrition at diagnosis and throughout therapy in pediatric patients with solid tumors: A single-institution study in a developing country.

Background: Changesin nutritional status can constitute a risk factor for reduced tolerance and effectiveness of antineoplastic treatment. Knowledge of the nutritional status of pediatric patients is important for implementing interventions to improve outcomes. We aimed to evaluate nutritional status at diagnosis and throughout therapy in pediatric patients with solid tumors.

Reference centile curves for mid-upper arm circumference for assessment of under- and overnutrition in school-aged Indian children and adolescents.

Objectives: Malnutrition is common in developing countries and is not restricted to young children. It has been suggested that measuring mid-upper arm circumference (MUAC) is an easy, accurate, and low-cost method of identifying malnutrition in the early stages. The aims of this study were to construct age- and sex-specific MUAC reference centiles, and to define and validate cutoffs for assessment of under- and overnutrition in Indian children 5 to 17 y of age.