Relationship between nutritional status and treatment-related neutropenia in children with nephroblastoma

  • Kelly S Draper University of KwaZulu-Natal
  • G P Hadley University of KwaZulu-Natal
  • Kirthee Pillay University of KwaZulu-Natal
  • Nicola Wiles University of KwaZulu-Natal
Keywords: cancer, children, malnutrition, nephroblastoma, treatment-related neutropenia

Abstract

Background: Assessment of nutritional status of paediatric oncology patients is crucial, as it may influence treatment and clinical outcomes. Concurrent malnutrition and cancer in children may lead to reduced chemotherapy delivery due to impaired tolerance and increased toxicity. Aim: This study aimed to determine the relationship between nutritional status and the prevalence, frequency and duration of treatment-related neutropenia in a cohort of South African children with nephroblastoma. Methods: Seventy-seven children between the ages of 1 and 12 years diagnosed with nephroblastoma at Inkosi Albert Luthuli Central Hospital (IALCH), Durban, between 2004 and 2012, were studied prospectively. Nutritional status was assessed using weight, height, mid-upper arm circumference (MUAC), triceps skinfold thickness (TSFT) and serum albumin. The administration of filgastrim (Neupogen®) was used as a surrogate for neutropenia and the frequency and duration of its use was recorded. Results: There was a significant relationship between the prevalence of treatment-induced neutropenia and malnutrition defined by MUAC. The mean frequency and duration of neutropenia was significantly higher in those classified as malnourished using MUAC. There was a positive correlation between frequency and duration of neutropenia. Conclusions: Malnutrition was prevalent among children with nephroblastoma. The prevalence of treatment-induced neutropenia was higher in those with poor nutritional status, identified by MUAC. Poor nutritional status according to MUAC was also linked to an increased frequency and duration of neutropenia. It is important to include MUAC in the nutritional assessment of children with nephroblastoma. (Full text available online at www.medpharm.tandfonline.com/ojcn) South Afr J Clin Nutr 2018; DOI: 10.1080/16070658.2017.140128

Author Biographies

Kelly S Draper, University of KwaZulu-Natal
Dietetics and Human Nutrition, University of KwaZulu-Natal, Pietermaritzburg, South Africa
G P Hadley, University of KwaZulu-Natal
Department of Paediatric Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Kirthee Pillay, University of KwaZulu-Natal
Dietetics and Human Nutrition, University of KwaZulu-Natal, Pietermaritzburg, South Africa
Nicola Wiles, University of KwaZulu-Natal
Dietetics and Human Nutrition, University of KwaZulu-Natal, Pietermaritzburg, South Africa
Published
2018-11-20
Section
Original Research