Nutritional status at diagnosis and its relationship with survival and relapse in Mexican children with acute lymphoblastic leukemia: a retrospective study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100967800 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2407 (Electronic) Linking ISSN: 14712407 NLM ISO Abbreviation: BMC Cancer Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Nutritional Status* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*/mortality ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*/diagnosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*/epidemiology ; Neoplasm Recurrence, Local*/epidemiology; Humans ; Female ; Male ; Mexico/epidemiology ; Retrospective Studies ; Child ; Child, Preschool ; Infant ; Adolescent ; Kaplan-Meier Estimate ; Survival Rate ; Recurrence ; Malnutrition

Competing Interests: Declarations. Ethics approval and consent to participate: The study was evaluated and approved by the Research and Ethics Committee of the Civil Hospital of Guadalajara "Dr. Juan I. Menchaca" (Comité de ética en investigación del Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" / CONBIOETICA-14-CEI-008-20161212) with the register number 00021. The requirement for informed consent was waived due to the retrospective nature of the study and the use of anonymized data. The study was also registered and approved by the Jalisco State Health Secretary (register number: 0410/20HCJIM/2020). The investigators complied with applicable requirements of the declaration of Helsinki [39]. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
Background & Aims: Childhood acute lymphoblastic leukemia (ALL) is a malignancy with varying survival rates across countries with low, middle, and high income. The assessment of nutritional status (NS) using anthropometric indicators has been explored for its potential relationship on treatment outcomes. This study analyzed a 3-year retrospective cohort of Mexican pediatric patients with ALL, exploring the association between NS at diagnosis and relapse/mortality.
Methods: Retrospective observational study. Medical records from 252 pediatric patients with ALL were included; anthropometric indicators (Z-scores) of body weight, height, mid-upper arm circumference (MUAC), and triceps and subscapular skinfolds (TSF and SSF, respectively) measurements were used to assess NS. The relapse/mortality data were collected from medical records. Kaplan-Meier (KM) functions and Cox regression models were performed to evaluate the effect of indicators on survival, relapse, and event (death or disease relapse).
Results: Patients with malnutrition showed a significantly lower survival rate according to their BMI (76% vs 63%, p = 0.049), while relapses were higher in the group with TSF < -2 SD (41% vs 12%, p = 0.007). Patients with stunting and TSF < -2 SD showed a higher risk of mortality (HR:6.214, 95%CI: 1.372 to 28.154; HR:2.91, 95%CI: 1.27 to 6.68, respectively), while in patients with higher MUAC Z-score showed a decrease in the mortality risk (HR:0.85, 95%CI:0.73 to 1.00).
Conclusions: The nutritional status assessed by anthropometric measurements was a strong predictor of survival and relapse outcomes 3y post/diagnosis in this cohort of pediatric patients with ALL.
(© 2025. The Author(s).)

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23649 International Atomic Energy Agency

Keywords: ALL, Acute lymphoblastic leukemia; BMI, body mass index; Childhood ALL; Nutritional status; Survival rate

Date Created: 20250221 Date Completed: 20250222 Latest Revision: 20250516

20250519

PMC11846316

10.1186/s12885-025-13729-5

39984931