Mb. Viana et al., MALNUTRITION AS A PROGNOSTIC FACTOR IN LYMPHOBLASTIC-LEUKEMIA - A MULTIVARIATE-ANALYSIS, Archives of Disease in Childhood, 71(4), 1994, pp. 304-310
One hundred and twenty eight Brazilian children with lymphoblastic leu
kaemia were intensively treated with a Berlin-Frankfurt-Munich based p
rotocol. More children had a white cell count above 50 x 10(9)/1 (31%)
then observed in developed countries. After a median follow up of 31
months (11-58 months), the estimated probability of relapse free survi
val was 41% (7%) for the whole group. After adjustment in the Cox's mu
ltivariate model, malnutrition was the most significant adverse factor
affecting duration of complete remission. Age above 8 years and high
peripheral white cell count were also significant adverse factors. Amo
ng the nutritional indices, the height for age and weight for age z sc
ores were both significant, whether the cut off points of z-2 or z = -
1.28 were chosen to define malnutrition. A strong statistical associat
ion between the two indices was found; the contribution of height for
age z score to the prediction of relapse free survival was more signif
icant. Children with height for age z score < -2 had a relapse risk of
8.2 (95% confidence interval 3.1 to 21.9) relative to children with z
score > -2. The results of this study suggest that socioeconomic and
nutritional factors should be considered in the prognostic evaluation
of children with leukaemia in developing countries.