Presentation (CTI)

OBJECTIVES: The primary objective was to evaluate the association between baseline nutritional status and induction-phase mortality and morbidities. Secondary objectives included assessment of remission status, chemotherapy-related toxicities and impact of nutritional status on duration of induction chemotherapy.
METHODS: An ambispective cohort study was conducted including children aged 1-18 years diagnosed with ALL between 2021 and 2024 at a tertiary care hospital in India. Baseline nutritional status was assessed using World Health organization (WHO) and Indian Academy of Pediatrics (IAP) classification. Induction-phase outcomes included mortality, morphological remission, minimal residual disease (MRD) status, chemotherapy-related toxicities, and duration of induction therapy.
RESULTS: Of 200 enrolled patients, 61.5% were malnourished at diagnosis. Severe acute malnutrition was seen in 13.5% and Moderate Acute malnutrition in 18.92%, similarly grade III and grade IV malnutrition was seen in 8.5%(n=17) and 22.5%(n=45) cases respectively. We found a statistically significant correlation (p=<0.001) between the poor nutritional status and mortalities, lower remission rates, increased febrile neutropenia, and prolonged induction duration (p < 0.001). Low serum albumin levels were also significantly associated with mortality (p = 0.009).
CONCLUSIONS: Baseline nutritional status significantly influences induction outcomes in pediatric ALL, with malnutrition correlating with increased mortality and poorer treatment responses. These findings underscore the critical need for comprehensive nutritional assessment at diagnosis and targeted interventions to improve prognoses in pediatric ALL patients, especially in resource-limited settings.