Association between the change in nutritional status in response to tube feeding and the occurrence of infections in children with a solid tumor

In 32 children with a solid tumor the association between the change in wei ght for height, in response to 4 weeks of tube feeding during the intensive phase of treatment, and the occurrence of leukopenia, leukopenic infection s, and nonleukopenic infections in a period thereafter (4-10 weeks) was stu died. Factors possibly influencing the change in weight for height during t he first 4 weeks of tube feeding were also assessed. A statistically signif icant negative correlation (rho = - 0.59; p < .001) was found between the c hange in z-score of weight for height in response to the first 4 weeks of t ube feeding, and the occurrence of nonleukopenic infections between 4 and 1 0 weeks. A reduced occurrence of nonleukopenic infections resulted in a sig nificant reduction of the number of days of infection-related hospital admi ssion (p =. 45; p =. 009), which, besides providing advantages for the pati ent, also had economical benefits. The change in weight for height in respo nse to tube feeding was mainly influenced by the incidence of therapy-induc ed vomiting (r = -.45; p =.02) and by the amount of energy provided by tube feeding (r =.47; p =.007). Eased on these findings, it is recommended that naso-gastric tube feeding be used in children with a solid tumor during th e early intensive phase of treatment, and that one should aim for a conside rable increase in weight for height during the first 4 weeks of administrat ion, since this has been shown to reduce the number of nonleukopenic infect ions in a subsequent period. The increase in weight for height may be impro ved by providing an optimal antiemetic protocol, which will increase energy uptake, and an energy-enriched formula, which will increase energy intake.