THE ASSOCIATION OF TRICEPS SKIN FOLD THICKNESS IN NUTRITIONAL STATUS OF CHILDREN WITH ALL AT DIAGNOSIS AND AFTER COMPLETION OF INDUCTION CHEMOTHERAPY

Dr. Mahbuba Rahman

ABSTRACT

Objective: To assess the association of triceps skin fold thickness in nutritional status of children with ALL at diagnosis and after completion of induction chemotherapy. Method: This prospective study was carried out at Department of Pediatric Hematology & oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka from Six months (1st October 2014 – 31st March 2015). Where sample was selected from the population by purposive sampling technique. Sample size was 80. Detail demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigation were done meticulously. Results: During the study, 58(72.5%) were underweight for weight-for-Age at diagnosis and 33(41.25%) after completion of induction. Prevalence of stunting was also improved after completion of induction therapy, 19(23.75%) were stunted for Height-for-Age at diagnosis and 14(17.5%) after completion of induction. Proportion of children with wasting showed reduction in wasting completion of induction therapy. 45(56.25%) were wasted for weight for height Age at diagnosis and 9(11.25%) after completion of induction. Table showed that 22(27.5%) patients malnutrition for MUAC-for-age at the time of diagnosis, and 32(40%) after induction therapy. Prevalence of isolated fat malnutrition (TSFT) was also improved after completion of induction therapy, 34(42.5%) were at diagnosis and 25(31.25%) after completion of induction. At the time of diagnosis of ALL Triceps skin fold thickness <5th centile were 34(42.5%) of cases, but after induction therapy it reduced to 25(31.25%) cases. At diagnosis Mean value of Triceps skin fold thickness (mm) were (6.58 ± 2.10), fat increased (triceps skin fold thickness) in post induction therapy patients (7.81 ± 2.63). 22(27.5%) patients malnutrition for MUAC-for-age at the time of diagnosis, and 32(40%) after induction therapy. Prevalence of isolated fat malnutrition (TSFT) was also improved after completion of induction therapy, 34(42.5%) were at diagnosis and 25(31.25%) after completion of induction. Conclusion: In conclusion, this study has shown that malnutrition was prevalent at diagnosis in significant portion of acute leukaemia cases. It was also concluded that best method in revealing malnutrition was TST measurement. Besides, it was obvious that more comprehensive studies are needed to determine the association of malnutrition to treatment and prognosis.

Keywords: Acute Lymphoblastic Leukemia (ALL), Cancer, induction chemotherapy.