University of Oulu

Aarnivala, H., Pokka, T., Soininen, R. et al. Eur J Pediatr (2019).

Trends in age- and sex-adjusted body mass index and the prevalence of malnutrition in children with cancer over 42 months after diagnosis : a single-center cohort study

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Author: Aarnivala, Henri1; Pokka, Tytti1; Soininen, Riina1;
Organizations: 1Department of Children and Adolescents, Oulu University Hospital and PEDEGO Research Unit, University of Oulu, Kajaanintie 52, 90220 Oulu, Finland
2Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: Springer Nature, 2019
Publish Date: 2019-11-07


The adequate nutritional status of pediatric cancer patients is particularly important to enable them to cope with the demands of the disease and its treatment and to maintain normal growth. Malnutrition and obesity have both been associated with reduced survival and increased drug toxicity. We investigated trends in the age- and sex-adjusted body mass index (ISO-BMI) and the prevalence of malnutrition in a Finnish cohort of 139 consecutive children receiving chemotherapy for cancer, with a follow-up period of 42 months after diagnosis. In total, 28% (39/139) of the patients experienced malnutrition (ISO-BMI < 17 or > 10% weight loss), and 12% (16/139) had a nasogastric tube or underwent gastrostomy. Patients with acute or chronic myeloid leukemia (5/10), central nervous system (CNS) tumors (5/13), or solid tumors (13/31) most frequently suffered from malnutrition. There was a significant increase in the ISO-BMI of patients with acute lymphoblastic leukemia (ALL) (+ 2.1 kg/m²) and lymphomas (+ 2.4 kg/m²) during the first 6 months, and the ISO-BMI of patients with ALL remained higher at 42 months compared to baseline (+ 1.9 kg/m²).

Conclusion: The cumulative incidence of malnutrition in Finnish pediatric cancer patients is comparable to that reported in other populations. The nutritional status of patients with acute myeloid leukemia, CNS tumors, or solid tumors should be monitored with extra care to facilitate early intervention in the case of impending malnutrition.

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Series: European journal of pediatrics
ISSN: 0340-6199
ISSN-E: 1432-1076
ISSN-L: 0340-6199
Volume: Ahead of print
Issue: Ahead of print
Pages: 1 - 8
DOI: 10.1007/s00431-019-03482-w
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: The study was funded with Finnish governmental research funds (VTR). Open access funding provided by University of Oulu including Oulu University Hospital.
Copyright information: © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.