Features Associated With Weight Loss and Growth Stunting for Young Children During Cancer Therapy

• Type of Material: Article
• Authors: Daniel Runco, Indiana University; Karen Wasilewski-Masker, Emory University; Claire Mazewski, Emory University; Briana Patterson, Emory University; Ann Mertens, Emory University
• Language: English
• Date: 2021-11-01
• Publisher: LIPPINCOTT WILLIAMS & WILKINS
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2021 Wolters Kluwer Health, Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/MPH.0000000000002246
• Title of Journal or Parent Work: JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY
• Volume: 43
• Issue: 8
• Start Page: 301
• End Page: 307
• Grant/Funding Information: Support was also received from the Emory University School of Medicine, Department of Pediatrics in the form of a Fellow Research Fund Award. Children’s Healthcare of Atlanta and Emory University Grant Editing and Manuscript Support Core assisted in manuscript review and preparation.
• Keywords: DIETETICS/AMERICAN SOCIETY; PEDIATRIC-PATIENTS; MEDULLOBLASTOMA; Science & Technology; ONCOLOGY; Pediatrics; CONSENSUS STATEMENT; ACADEMY; cancer; ENTERAL NUTRITION; pediatric oncology; nutrition; infant; cancer cachexia; ACUTE LYMPHOBLASTIC-LEUKEMIA; Life Sciences & Biomedicine; GUIDELINES NUTRITION SUPPORT; MALNUTRITION; Hematology; Oncology

Abstract

Features associated with malnutrition are poorly elucidated in pediatric cancer care. We aimed to better understand characteristics associated with weight-for-height (WHZ) and height-for-age (HAZ) changes for infants and young children during cancer treatment. This retrospective study included 434 patients diagnosed <3 years old from 2007 to 2015 at a large pediatric cancer center. Patients starting treatment outside our center, those with relapsed or secondary malignancies, or with inaccurate information were excluded. Abstracted weights and heights for a 24-month period after treatment initiation were converted to sex-specific and age-specific z scores. Although not statistically different at baseline, patients with hematologic malignancies gained weight over time, while other tumor types did not. Higher treatment intensity and younger age at diagnosis increased odds of clinically significant weight loss. Older children had higher HAZ at diagnosis and HAZ also significantly decreased over time for all examined risk factors, which is distinctly different from patterns in WHZ over time. In conclusion, WHZ and HAZ are affected differently by cancer treatment in infants and young children. We identify key risk factors for weight loss and growth stunting which will be necessary to develop prospective trials to examine anthropometric, biochemical, and patient recorded outcomes around nutrition.