CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2020; 41(03): 368-371
DOI: 10.4103/ijmpo.ijmpo_226_18
Original Article

Impact of Sociodemographic Factors and Nutrition on the Duration of Induction Phase of Chemotherapy in children with Acute lymphoblastic leukemia: A Tertiary Center Experience from North India

Priyanka Aggarwal
Department of Pediatrics, Division of Pediatric Hematology Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
,
TB Singh
Department of Community Medicine, Division of Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
,
Vineeta Gupta
Department of Pediatrics, Division of Pediatric Hematology Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
› Author Affiliations
Financial support and sponsorship Nil.

Abstract

Background: Immunocompromised patients are at increased risk of infections, especially those living in poor hygienic conditions. Aims and Objectives: This study aims to assess the effect of weight, immunization status of the child at the start of treatment along with the socioeconomic status (SES), and demographic parameters, i.e., type of house, sanitary facility (SF), and source of drinking water on the duration of induction phase of chemotherapy (delayed if the patient received chemotherapy for >29 days). Materials and Methods: 110 pediatric acute lymphoblastic leukemia patients aged 1.5–14 years who underwent induction of remission from June 2015 to February 2018 were included. The immunization status and weight of the child were recorded at the start of treatment. SES was assessed using modified Kuppuswami scale and a questionnaire was used to determine various sociodemographic parameters. Results: The patients not immunized as per age (P = 0.000) and having poor demographic parameters, i.e., mud house (P = 0.000), absence of SF (P = 0.013), and nonfiltered drinking water (P = 0.005), had significant delay. The duration of induction phase of chemotherapy was not delayed with poor SES (P = 0.832). Although the duration was delayed in patients with weight ≥10 percentile, it was not statistically significant (P = 0.079). On analyzing the three demographic parameters together as Water-Sanitary Facility-Housing (WaSH) Score (0–4), the duration was also significantly delayed if the patients had WaSH score <2. Conclusion: The duration of induction phase of chemotherapy is delayed with inadequate immunization status and poor hygiene of the child.



Publication History

Received: 16 October 2018

Accepted: 17 September 2019

Article published online:
28 June 2021

© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 National Cancer Institute. SEER Cancer Statistics Review. Bethesda, MD: National Cancer Institute. Available from: http:// seer.cancer.gov/faststats/selections.php?#Output. [Last accessed on 2016 Apr 04]
  • 2 Gatta G, Capocaccia R, Stiller C, Kaatsch P, Berrino F, Terenziani M. et al. Childhood cancer survival trends in Europe: A EUROCARE working group study. J Clin Oncol 2005; 23: 3742-51
  • 3 World Health Organization and the United Nations Children's Fund. Progress on Drinking Water, Sanitation and Hygiene: 2017 Update and SDG Baselines.Geneva: World Health Organization and the United Nations Children's Fund; 2017
  • 4 Coebergh JW, van der Does-van den BergA, Hop WC, van WeerdenF, Rammeloo JA, van Steensel HA. et al Small in uence of parental educational level on the survival of children with leukaemia in the Netherlands between 1973 and 1979. Eur J Cancer 1996; 32A: 286-9
  • 5 Syse A, Lyngstad TH, Kravdal O. Is mortality after childhood cancer dependent on social or economic resources of parents? A population-based study. Int J Cancer 2012; 130: 1870-8
  • 6 Totadri S, Trehan A, Kaur A, Bansal D, Jain R. Does distance between residence and treating center impact outcome in childhood acute lymphoblastic leukemia? Report from a tertiary care center in North India. Pediatr Hematol Oncol J 2016; 1: S1-33
  • 7 Advani S, Pai S, Venzon D, Adde M, Kurkure PK, Nair CN. et al. Acute lymphoblastic leukemia in India: An analysis of prognostic factors using a single treatment regimen. Ann Oncol 1999; 10: 167-76
  • 8 Hunger SP, Lu X, Devidas M, Camitta BM, Gaynon PS, Winick NJ. et al. Improved survival for children and adolescents with acute lymphoblastic leukemia between 1990 and 2005: A report from the children's oncology group. J Clin Oncol 2012; 30: 1663-9
  • 9 Bauer J, Jürgens H, Frühwald MC. Important aspects of nutrition in children with cancer. Adv Nutr 2011; 2: 67-77
  • 10 Tisdale MJ. Cancer cachexia: Metabolic alterations and clinical manifestations. Nutrition 1997; 13: 1-7
  • 11 Orgel E, Sposto R, Malvar J, Seibel NL, Ladas E, Gaynon PS. et al. Impact on survival and toxicity by duration of weight extremes during treatment for pediatric acute lymphoblastic leukemia: A report from the children's oncology group. J Clin Oncol 2014; 32: 1331-7
  • 12 Roy A, Saha A, Chakraborty S, Chattopadhyay S, Sur PK. Effects of pre-existing undernutrition on treatment related complications and treatment outcomes in children with acute lymphoblastic leukemia: A tertiary care centre experience. Clin Cancer Invest J 2013; 2: 143-8
  • 13 Trehan A, Prabhu V, Bansal D. The impact of weight for age on survival in acute lymphoblastic leukemia: Report from a tertiary care center in North India. Indian J Cancer 2015; 52: 203-6
  • 14 Bona K, Blonquist TM, Neuberg DS, Silverman LB, Wolfe J. Impact of socioeconomic status on timing of relapse and overall survival for children treated on Dana-Farber cancer institute ALL consortium protocols (2000-2010). Pediatr Blood Cancer 2016; 63: 1012-8
  • 15 Gupta S, Wilejto M, Pole JD, Guttmann A, Sung L. Low socioeconomic status is associated with worse survival in children with cancer: A systematic review. PLoS One 2014; 9: e89482
  • 16 Totadri S, Trehan A, Kaur A, Bansal D, Jain R. Socio-economic status and survival in children with acute lymphoblastic leukemia. Pediatr Hematol Oncol J 2016; 1: S1-33