Malnutrition as a prognostic factor in lymphoblastic leukaemia: a multivariate analysis.

Autor: Viana, Marcos Borato, Murao, Mitiko, Ramos, Gilberto, Oliveira, Hilda Maria, de Carvalho, Romeu Ibrahim, de Bastos, Marcos, Colosimo, Enrico Antonio, Silvestrini, Wagner Sergio, Viana, M B, Murao, M, Ramos, G, Oliveira, H M, de Carvalho, R I, de Bastos, M, Colosimo, E A, Silvestrini, W S
Zdroj: Archives of Disease in Childhood; Oct1994, Vol. 71 Issue 4, p304-310, 7p, 5 Charts, 2 Graphs
Abstrakt: One hundred and twenty eight Brazilian children with lymphoblastic leukaemia were intensively treated with a Berlin-Frankfurt-Munich based protocol. More children had a white cell count above 50 x 10(9)/l (31%) then observed in developed countries. After a median follow up of 31 months (11-58 months), the estimated probability of relapse free survival was 41% (7%) for the whole group. After adjustment in the Cox's multivariate 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. Among the nutritional indices, the height for age and weight for age z scores were both significant, whether the cut off points of z-2 or z = -1.28 were chosen to define malnutrition. A strong statistical association between the two indices was found; the contribution of height for age z score to the prediction of relapse free survival was more significant. 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. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index