The Influence of Nutritional Status at Diagnosis of Childhood B-Cell Acute Lymphoblastic Leukemia on Survival Rates: Data from a Hispanic Cohort

Abstract

The impact of nutritional status at diagnosis of childhood acute lymphoblastic leukemia (ALL) on survival rates was assessed in a Hispanic cohort. Children <16 years with newly diagnosed ALL-B from 2011 to 2019 were studied. Overweight and obesity were classified by body mass index (BMI) and Z-score according to WHO and CDC criteria. BMI, weight percentiles for age and Z-Score were assessed using the WHO Anthro (0-5 years) and AnthroPlus (5-19 years) programs. Cox model was used to estimate risk factors for relapse and death; differences between groups were assessed with Student’s T test for parametric and Mann-Whitney U test for non-parametric variables. Disease-free survival (DFS) and overall survival (OS) were determined by the Kaplan-Meier method, calculating time, status, cumulative survival and standard error with a 95% confidence interval. Equal data distribution was estimated with the log-rank test. One-hundred and seventy-two B-ALL children were studied. The overweight-obese group had a non-significant lower DFS (CDC: 54% vs. 60%, p = 0.80; WHO: 57% vs. 64%, p = 0.89) and OS rate (CDC:76% vs. 82%, p = 0.38; WHO:65% vs. 81%, p = 0.13). An association between nutritional status determined by CDC and WHO criteria at diagnosis of B-cell ALL and survival rates was not documented.

Acknowledgments

We thank Sergio Lozano-Rodriguez, M.D., for his critical review of the manuscript.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Author Contributions

José C. Jaime-Pérez: Conception of the idea and design of the study, drafting and final approval of the version to be submitted.

Grecia A. Turrubiates-Hernández: Interpretation of data, drafting, final approval of the version to be submitted.

Gerardo García-Salas: Data analysis, critical review for important intellectual content, final approval of the version to be submitted.

Anel De la Torre-Salinas: Data collection, analysis and interpretation of data, and final approval of the version to be submitted.

Patricia Áncer-Rodríguez: Data collection and analysis, critical review for important intellectual content, final approval of the version to be submitted.

Laura Villarreal-Martínez: Data collection, final approval of the version to be submitted.

David Gómez-Almaguer: Critical review for important intellectual content and final approval of the version to be submitted.

Hospital/Academic Institution: Dr. Jose Eleuterio González University Hospital and School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México.