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The Effect of Neutropenic Diet Adherence On Malnutrition and Duration of Hospital Stay In Children With Acute Lymphoblastic Leukemia

Year 2020, Issue: 4, 631 - 640, 01.12.2020

Emine Betül Polat Binnur Okan Bakır Ali Ayçiçek

Abstract

Objectives: Neutropenic diet ND was once considered to be important for the protection of patients from neutropenia when chemotherapy continued. The nutritional problems that neutropenic patients are struggling with include decreased quality of life, inadequate nutrition, prolonged hospital stay, gastrointestinal complications, avoidance of food and decrease in cell mediated immunity resulting from vitamin deficiencies. This cross-sectional trial aimed to evaluate the effect of ND adherence on malnutrition and hospital stay.Material and Method: Between 1st July to 1st December 2017, 60 consecutive children with acute lymphoblastic leukemia treated in University of Health Science Kanuni Sultan Süleyman Research and Training Hospital who were between 1 to 18 years of age and of whom 58.3% n=35 were boys and 41.7% n=25 were girls included in the study. Baseline data collection included demographic and anthropometric information body weight, height, mid upper arm circumference, skinfold thickness ; medical history and adherence to ND was evaluated with a dietary survey method with questions asking actual dietary adherence based on the frequency of food consumed within limited food categories.Results: The adherence rate was 61.7% n=37 for ND. The hospital stay was actually significantly lower in the low ND adherence p=0.027 . Patients in the ND adhering group had no statistically significant difference in malnutrition risk compared to ND incompatible patients p=0.524 .Conclusion: ND extends the length of stay in the hospital while it does not affect malnutrition status. Dietary guidelines with fewer limitations for children with cancer would be helpful for improving nutritional status and shortening hospital stays

Keywords

Acute lymphoblastic leukemia malnutrition diet

References

  • Kaatsch P. Epidemiology of childhood cancer. Cancer Treat Rev 2010;36:277–85.
  • Arpaci T, Kilicarslan Toruner E, Altay N. Assessment of Nutritional Problems in Pediatric Patients with Cancer and the Information Needs of Their Parents: A Parental Perspective. Asia Pac J Oncol Nurs 2018;5:231–6. [CrossRef]
  • Vázquez de la Torre MJ, Stein K, Vásquez Garibay EM, Kumazawa- Ichikawa MR, Troyo-Sanromán R, Flores AGS, Sánchez-Zubieta F. Patient-Generated Subjective Global Assessment of nutritional status in pediatric patients with recent cancer diagnosis. Nutr Hosp 2017;34:1050–8. [CrossRef]
  • Zapolska J, Witczak-Sawczuk K, Krawczuk-Rybak M, Sawicka- Zukowska M, Smarkusz J, Ostrowska L. Comparison of diet and physical activity of children and adolescents with patients after cancer treatment. Rocz Panstw Zakl Hig 2018;69:79–86. https:// www.researchgate.net/publication/323684298_Comparison_of_ diet_and_physical_activity_of_children_and_adolescents_with_ patients_after_cancer_treatment
  • 28:126–33. [CrossRef]
  • Garófolo A. Neutropenic diet and quality of food: a critical analysis. Rev Bras Hematol Hemoter 2013;35:79–80. [CrossRef]
  • Braun LE, Chen H, Frangoul H. Significant inconsistency among pediatric oncologists in the use of the neutropenic diet. Pediatr Blood Cancer 2014;61:1806–10. [CrossRef]
  • Jubelirer SJ. The benefit of the neutropenic diet: fact or fiction? Oncologist 2011;16:704–7. [CrossRef]
  • Martín-Trejo JA, Nşñez-Enríquez JC, Fajardo-Gutiérrez A, Medina- Sansón A, Flores-Lujano J, Jiménez-Hernández E, et al. Early mortality in children with acute lymphoblastic leukemia in a developing country: the role of malnutrition at diagnosis. A multicenter cohort MIGICCL study. Leuk Lymphoma 2017;58:898–908. [CrossRef]
  • de Onis M, Garza C, Onyango AW, Borghi E. Comparison of the WHO child growth standards and the CDC 2000 growth charts. J Nutr 2007;137:144–8. [CrossRef]
  • Campbell M, Castillo L, Riccheri C, Janic D, Jazbec J, et al. A Randomized Trial of the I-BFM-SG for the Management of Childhood non-B Acute Lymphoblastic Leukemia. Final Version of Therapy Protocol from August-14-2009. p.1–178. http://www.bialaczka.org/ wp-content/uploads/2016/10/ALLIC_BFM_2009.pdf
  • Whitney EN, Rolfes SR. Understanding Nutrition, 9th ed. Stanford USA: Wadsworth, Thomson Learning; 2002.
  • Lehrnbecher T, Laws HJ, Boehm A, Dworzak M, Janssen G, Simon A, Groll AH. Compliance with anti-infective preventive measures: A multicentre survey among paediatric oncology patients. Eur J Cancer 2008;44:1861–5. [CrossRef]
  • Maia JE, da Cruz LB, Gregianin LJ. Microbiological profile and nutritional quality of a regular diet compared to a neutropenic diet in a pediatric oncology unit. Pediatr Blood Cancer 2018;65:e26828. [CrossRef]
  • Gardner A, Mattiuzzi G, Faderl S, Borthakur G, Manero GG, Pierce S, et al. Randomized comparison of cooked and noncooked diets in patients undergoing remission induction therapy for acute myeloid leukemia. J Clin Oncol 2008;26:5684–8. [CrossRef]
  • Paltiel O, Tikellis G, Linet M, Golding J, Lemeshow S, Phillips G, et al. Birthweight and Childhood Cancer: Preliminary Findings from the International Childhood Cancer Cohort Consortium (I4C). Paediatr Perinat Epidemiol 2015;29:335–45. [CrossRef]
  • Schraw JM, Dong YQ, Okcu MF, Scheurer ME, Forman MR. Do longer formula feeding and later introduction of solids increase risk for pediatric acute lymphoblastic leukemia? Cancer Causes Control 2014;25:73–80. [CrossRef]
  • Ladas EJ, Orjuela M, Stevenson K, Cole PD, Lin M, Athale UH, et al. Dietary intake and childhood leukemia: The Diet and Acute Lymphoblastic Leukemia Treatment (DALLT) cohort study. Nutrition 2016;32:1103–9.e1.
  • Ward E, DeSantis C, Robbins A, Kohler B, Jemal A. Childhood and adolescent cancer statistics, 2014. CA Cancer J Clin 2014;64:83–103. [CrossRef]
  • Orgel E, Genkinger JM, Aggarwal D, Sung L, Nieder M, Ladas EJ. Association of body mass index and survival in pediatric leukemia: a meta-analysis. Am J Clin Nutr 2016;103:808–17. [CrossRef]
  • Inaba H, Surprise HC, Pounds S, Cao X, Howard SC, Ringwald-Smith K, et al. Effect of body mass index on the outcome of children with acute myeloid leukemia. Cancer 2012;118:5989–96. [CrossRef]
  • Kwan ML, Buffler PA, Wiemels JL, Metayer C, Selvin S, Ducore JM, Block G. Breastfeeding patterns and risk of childhood acute lymphoblastic leukaemia. Br J Cancer 2005;93:379–84. [CrossRef]
  • Karimi M, Haghighat M, Dialameh Z, Tahmasbi L, Parand S, Bardestani M. Breastfeeding as a Protective Effect Against Childhood Leukemia and Lymphoma. Iran Red Crescent Med J 2016;18:e29771. [CrossRef]
  • Jourdan-Da SN, Perel Y, Méchinaud F, Plouvier E, Gandemer V, Lutz P, et al. Infectious diseases in the first year of life, perinatal characteristics and childhood acute leukaemia. Br J Cancer 2004;90:139–45. [CrossRef]
  • Jiménez-Hernández E, Fajardo-Gutiérrez A, Nşñez-Enriquez JC, Martín-Trejo JA, Espinoza-Hernández LE, Flores-Lujano J, et al. A greater birthweight increases the risk of acute leukemias in Mexican children-experience from the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia (MIGICCL). Cancer Med 2018;7:1528–36. [CrossRef]
  • Milne E, Greenop KR, Metayer C, Schüz J, Petridou E, Pombo-de- Oliveira MS, et al. Fetal Growth and Childhood Acute Lymphoblastic Leukemia: Findings from the Childhood Leukemia International Consortium (CLIC). Int J Cancer 2013;133:2968–79. [CrossRef]
  • Sala A, Rossi E, Antillon F. Nutritional status at diagnosis in children and adolescents with cancer in the Asociacion de Hemato-Oncologia Pediatrica de Centro America (AHOPCA) countries: preliminary results from Guatemala. Pediatr Blood Cancer 2008;50:499–501. [CrossRef]
  • Ladas EJ, Sacks N, Brophy P, Rogers PC. Standards of nutritional care in pediatric oncology: results from a nationwide survey on the standards of practice in pediatric oncology. A Children’s Oncology Group study. Pediatr Blood Cancer 2006;46:339–44. [CrossRef]
  • Lange BJ, Gerbing RB, Feusner J, Skolnik J, Sacks N, Smith FO, Alonzo TA. Mortality in overweight and underweight children with acute myeloid leukemia. JAMA 2005;293:203–11. [CrossRef]
  • Esfahani A, Ghoreishi Z, Abedi MM, Miran MA, Sanaat Z, Ostadrahimi A, et al. Nutritional assessment of patients with acute leukemia during induction chemotherapy: association with hospital outcomes. Leuk Lymphoma 2014;55:1743–50. [CrossRef]
  • Moody K, Meyer M, Mancuso CA, Charlson M, Robbins L. Exploring concerns of children with cancer. Support Care Cancer 2006;14:960– 6. [CrossRef]
  • Moody K, Charlson ME, Finlay J. The neutropenic diet: what’s the evidence? J Pediatr Hematol Oncol 2002;24:717–21. [CrossRef]
  • Trifilio S, Helenowski I, Giel M, Gobel B, Pi J, Greenberg D, Mehta J. Questioning the role of a neutropenic diet following hematopoetic stem cell transplantation. Biol Blood Marrow Transplant 2012;18:1385–90. [CrossRef]
  • Tramsen L, Salzmann-Manrique E, Bochennek K, Klingebiel T, Reinhardt D, Creutzig U, et al. Lack of Effectiveness of Neutropenic Diet and Social Restrictions as Anti-Infective Measures in Children With Acute Myeloid Leukemia: An Analysis of the AML-BFM 2004. Trial. J Clin Oncol 2016;34:2776–83. [CrossRef]

ÇOCUKLUK ÇAĞI AKUT LENFOBLASTIK LÖSEMI TEDAVISI ALAN HASTALARIN NÖTROPENIK DIYET UYUMUNUN MALNUTRISYONA VE HASTANEDE YATIŞ SÜRESINE ETKISI

Year 2020, Issue: 4, 631 - 640, 01.12.2020

Emine Betül Polat Binnur Okan Bakır Ali Ayçiçek

Abstract

Amaç: Nötropenik diyetlerin ND , kemoterapi tedavisi alan hastalarda sık görülen nötropeni nedeniyle enfekte olma durumuna karşı korunmalarında önemli olduğu düşünülmektedir. Nötropeniyle mücadele eden hastalarda görülen diyete ait zorluklar arasında; yaşam kalitesinin azalması, yetersiz beslenme, hastanede kalış süresinin uzaması, gastrointestinal yan etkiler, yemekten kaçınma ve vitamin eksikliğinden kaynaklanan bağışıklığın zayıflaması sayılabilmektedir. Bu kesitsel çalışmada, nötropenik diyete uyumun malnutrisyona ve hastanede yatış süresine etkisini değerlendirmek amaçlanmıştır.Gereç ve Yöntem: 1 Temmuz– 1 Kasım 2017 tarihleri arasında Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi’nde tedavi alan Akut Lenfoblastik Lösemi’li %58,3’i n=35 erkek ve %41,7’si n=25 kızlardan oluşan 60 çocuk hasta çalışmaya dahil edilmiştir. Demografik bilgi toplanmış ve antropometrik ölçümler vücut ağırlığı, boy uzunluğu, üst orta kol çevresi, deri kıvrım kalınlığı , tıbbi öykü alınmış ve ND uyumu kısıtlanmış besin katogorileri içinde bulunan besinlerin tüketim sıklığına yönelik bir anket ile sorgulanmıştır.Bulgular: Nötropenik diyete uyum oranı %61,7 n=37 olarak saptanmış, hastanede yatış süresi nötropenik diyet uyumu daha az olan hastalarda anlamlı olarak daha düşük bulunmuştur p=0,027 . Nötropenik diyet uyumu ile malnütrisyon riski arasında istatistiksel olarak anlamlı bir sonuç bulunanamıştır p=0,524 .Sonuç: Nötropenik diyetin hastanede kalış süresini uzattığı ancak malnutrisyona etkisi olmadığı bulunmuştur. Çocukluk çağı kanserleri için kısıtlaması daha az olan diyet önerileri, beslenme durumunun iyileşmesine ve hastanede kalış süresine olumlu katkıda bulunacaktır

Keywords

Akut lenfoblastik lösemi malnutrisyon diyet

References

  • Kaatsch P. Epidemiology of childhood cancer. Cancer Treat Rev 2010;36:277–85.
  • Arpaci T, Kilicarslan Toruner E, Altay N. Assessment of Nutritional Problems in Pediatric Patients with Cancer and the Information Needs of Their Parents: A Parental Perspective. Asia Pac J Oncol Nurs 2018;5:231–6. [CrossRef]
  • Vázquez de la Torre MJ, Stein K, Vásquez Garibay EM, Kumazawa- Ichikawa MR, Troyo-Sanromán R, Flores AGS, Sánchez-Zubieta F. Patient-Generated Subjective Global Assessment of nutritional status in pediatric patients with recent cancer diagnosis. Nutr Hosp 2017;34:1050–8. [CrossRef]
  • Zapolska J, Witczak-Sawczuk K, Krawczuk-Rybak M, Sawicka- Zukowska M, Smarkusz J, Ostrowska L. Comparison of diet and physical activity of children and adolescents with patients after cancer treatment. Rocz Panstw Zakl Hig 2018;69:79–86. https:// www.researchgate.net/publication/323684298_Comparison_of_ diet_and_physical_activity_of_children_and_adolescents_with_ patients_after_cancer_treatment
  • 28:126–33. [CrossRef]
  • Garófolo A. Neutropenic diet and quality of food: a critical analysis. Rev Bras Hematol Hemoter 2013;35:79–80. [CrossRef]
  • Braun LE, Chen H, Frangoul H. Significant inconsistency among pediatric oncologists in the use of the neutropenic diet. Pediatr Blood Cancer 2014;61:1806–10. [CrossRef]
  • Jubelirer SJ. The benefit of the neutropenic diet: fact or fiction? Oncologist 2011;16:704–7. [CrossRef]
  • Martín-Trejo JA, Nşñez-Enríquez JC, Fajardo-Gutiérrez A, Medina- Sansón A, Flores-Lujano J, Jiménez-Hernández E, et al. Early mortality in children with acute lymphoblastic leukemia in a developing country: the role of malnutrition at diagnosis. A multicenter cohort MIGICCL study. Leuk Lymphoma 2017;58:898–908. [CrossRef]
  • de Onis M, Garza C, Onyango AW, Borghi E. Comparison of the WHO child growth standards and the CDC 2000 growth charts. J Nutr 2007;137:144–8. [CrossRef]
  • Campbell M, Castillo L, Riccheri C, Janic D, Jazbec J, et al. A Randomized Trial of the I-BFM-SG for the Management of Childhood non-B Acute Lymphoblastic Leukemia. Final Version of Therapy Protocol from August-14-2009. p.1–178. http://www.bialaczka.org/ wp-content/uploads/2016/10/ALLIC_BFM_2009.pdf
  • Whitney EN, Rolfes SR. Understanding Nutrition, 9th ed. Stanford USA: Wadsworth, Thomson Learning; 2002.
  • Lehrnbecher T, Laws HJ, Boehm A, Dworzak M, Janssen G, Simon A, Groll AH. Compliance with anti-infective preventive measures: A multicentre survey among paediatric oncology patients. Eur J Cancer 2008;44:1861–5. [CrossRef]
  • Maia JE, da Cruz LB, Gregianin LJ. Microbiological profile and nutritional quality of a regular diet compared to a neutropenic diet in a pediatric oncology unit. Pediatr Blood Cancer 2018;65:e26828. [CrossRef]
  • Gardner A, Mattiuzzi G, Faderl S, Borthakur G, Manero GG, Pierce S, et al. Randomized comparison of cooked and noncooked diets in patients undergoing remission induction therapy for acute myeloid leukemia. J Clin Oncol 2008;26:5684–8. [CrossRef]
  • Paltiel O, Tikellis G, Linet M, Golding J, Lemeshow S, Phillips G, et al. Birthweight and Childhood Cancer: Preliminary Findings from the International Childhood Cancer Cohort Consortium (I4C). Paediatr Perinat Epidemiol 2015;29:335–45. [CrossRef]
  • Schraw JM, Dong YQ, Okcu MF, Scheurer ME, Forman MR. Do longer formula feeding and later introduction of solids increase risk for pediatric acute lymphoblastic leukemia? Cancer Causes Control 2014;25:73–80. [CrossRef]
  • Ladas EJ, Orjuela M, Stevenson K, Cole PD, Lin M, Athale UH, et al. Dietary intake and childhood leukemia: The Diet and Acute Lymphoblastic Leukemia Treatment (DALLT) cohort study. Nutrition 2016;32:1103–9.e1.
  • Ward E, DeSantis C, Robbins A, Kohler B, Jemal A. Childhood and adolescent cancer statistics, 2014. CA Cancer J Clin 2014;64:83–103. [CrossRef]
  • Orgel E, Genkinger JM, Aggarwal D, Sung L, Nieder M, Ladas EJ. Association of body mass index and survival in pediatric leukemia: a meta-analysis. Am J Clin Nutr 2016;103:808–17. [CrossRef]
  • Inaba H, Surprise HC, Pounds S, Cao X, Howard SC, Ringwald-Smith K, et al. Effect of body mass index on the outcome of children with acute myeloid leukemia. Cancer 2012;118:5989–96. [CrossRef]
  • Kwan ML, Buffler PA, Wiemels JL, Metayer C, Selvin S, Ducore JM, Block G. Breastfeeding patterns and risk of childhood acute lymphoblastic leukaemia. Br J Cancer 2005;93:379–84. [CrossRef]
  • Karimi M, Haghighat M, Dialameh Z, Tahmasbi L, Parand S, Bardestani M. Breastfeeding as a Protective Effect Against Childhood Leukemia and Lymphoma. Iran Red Crescent Med J 2016;18:e29771. [CrossRef]
  • Jourdan-Da SN, Perel Y, Méchinaud F, Plouvier E, Gandemer V, Lutz P, et al. Infectious diseases in the first year of life, perinatal characteristics and childhood acute leukaemia. Br J Cancer 2004;90:139–45. [CrossRef]
  • Jiménez-Hernández E, Fajardo-Gutiérrez A, Nşñez-Enriquez JC, Martín-Trejo JA, Espinoza-Hernández LE, Flores-Lujano J, et al. A greater birthweight increases the risk of acute leukemias in Mexican children-experience from the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia (MIGICCL). Cancer Med 2018;7:1528–36. [CrossRef]
  • Milne E, Greenop KR, Metayer C, Schüz J, Petridou E, Pombo-de- Oliveira MS, et al. Fetal Growth and Childhood Acute Lymphoblastic Leukemia: Findings from the Childhood Leukemia International Consortium (CLIC). Int J Cancer 2013;133:2968–79. [CrossRef]
  • Sala A, Rossi E, Antillon F. Nutritional status at diagnosis in children and adolescents with cancer in the Asociacion de Hemato-Oncologia Pediatrica de Centro America (AHOPCA) countries: preliminary results from Guatemala. Pediatr Blood Cancer 2008;50:499–501. [CrossRef]
  • Ladas EJ, Sacks N, Brophy P, Rogers PC. Standards of nutritional care in pediatric oncology: results from a nationwide survey on the standards of practice in pediatric oncology. A Children’s Oncology Group study. Pediatr Blood Cancer 2006;46:339–44. [CrossRef]
  • Lange BJ, Gerbing RB, Feusner J, Skolnik J, Sacks N, Smith FO, Alonzo TA. Mortality in overweight and underweight children with acute myeloid leukemia. JAMA 2005;293:203–11. [CrossRef]
  • Esfahani A, Ghoreishi Z, Abedi MM, Miran MA, Sanaat Z, Ostadrahimi A, et al. Nutritional assessment of patients with acute leukemia during induction chemotherapy: association with hospital outcomes. Leuk Lymphoma 2014;55:1743–50. [CrossRef]
  • Moody K, Meyer M, Mancuso CA, Charlson M, Robbins L. Exploring concerns of children with cancer. Support Care Cancer 2006;14:960– 6. [CrossRef]
  • Moody K, Charlson ME, Finlay J. The neutropenic diet: what’s the evidence? J Pediatr Hematol Oncol 2002;24:717–21. [CrossRef]
  • Trifilio S, Helenowski I, Giel M, Gobel B, Pi J, Greenberg D, Mehta J. Questioning the role of a neutropenic diet following hematopoetic stem cell transplantation. Biol Blood Marrow Transplant 2012;18:1385–90. [CrossRef]
  • Tramsen L, Salzmann-Manrique E, Bochennek K, Klingebiel T, Reinhardt D, Creutzig U, et al. Lack of Effectiveness of Neutropenic Diet and Social Restrictions as Anti-Infective Measures in Children With Acute Myeloid Leukemia: An Analysis of the AML-BFM 2004. Trial. J Clin Oncol 2016;34:2776–83. [CrossRef]
There are 34 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Emine Betül Polat

Binnur Okan Bakır

Ali Ayçiçek

Publication Date December 1, 2020
Published in Issue Year 2020Issue: 4

Cite

EndNote Polat EB, Bakır BO, Ayçiçek A (December 1, 2020) The Effect of Neutropenic Diet Adherence On Malnutrition and Duration of Hospital Stay In Children With Acute Lymphoblastic Leukemia. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 4 631–640.