Department of Paediatrics, Greater Accra Regional Hospital, Accra, Ghana.
Department of Child Health, University of Ghana Medical School, Accra, Ghana.
PLoS One. 2024 Mar 28;19(3):e0301208. doi: 10.1371/journal.pone.0301208. eCollection 2024.
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.
儿童癌症患者营养不良与癌症治疗期间的并发症有关。本研究的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。这是加纳科勒布教学医院儿科肿瘤病房的一项基于医院的前瞻性队列研究，纳入了年龄≤ 12 岁的新诊断癌症患儿。在登记时获取了社会人口统计学信息、癌症特征和人体测量数据。参与者从开始化疗起随访 12 周，并记录了贫血和血小板减少症需要输血、中性粒细胞减少症持续时间延长导致治疗延迟、发热性中性粒细胞减少症、黏膜炎和死亡等特定的治疗相关并发症。共招募了 133 名参与者，中位年龄为 4.5 岁。81 名（60.9%）被诊断为实体瘤，31 名（23.3%）患有白血病，21 名（15.8%）患有淋巴瘤。在所评估的人体测量参数中，只有手臂人体测量学（使用上臂肌肉区（UAMA）和中上臂周长（MUAC））与并发症相关。消瘦者更有可能发生贫血和黏膜炎。然而，与低 UAMA 相比，平均 UAMA 较高（p = 0.043）和低平均 UAMA（p = 0.049）的参与者中，出现中性粒细胞减少症持续时间延长的发生率显著更高。与营养良好的参与者相比，通过 MUAC 消瘦的参与者发生中性粒细胞减少症的风险也显著降低（p = 0.045）。23 名参与者（17.3%）死亡，其中更多（11/44；25%）是通过 MUAC 消瘦的参与者。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，特别是在合并疾病普遍存在的情况下。
