MALNUTRITION AS A PROGNOSTIC FACTOR IN LYMPHOBLASTIC-LEUKEMIA - A MULTIVARIATE-ANALYSIS

Citation
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
Citations number
32
Categorie Soggetti
Pediatrics
ISSN journal
00039888
Volume
71
Issue
4
Year of publication
1994
Pages
304 - 310
Database
ISI
SICI code
0003-9888(1994)71:4<304:MAAPFI>2.0.ZU;2-Y
Abstract
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.