How oral supplements help reduce chemo-induced complications in child leukaemia patients

Oral nutritional supplements (ONS) can benefit children with acute lymphoblastic leukaemia (ALL) in chemotherapy, according to a Chinese population study.

Paediatric ALL patients who are receiving chemotherapeutic treatment tend to suffer from appetite loss, nausea, vomiting, and a reduced diet, all effects of chemotherapy drugs.

This also results in damage to the gastrointestinal tract, affecting food digestion, impairing the tract’s absorption function, and predisposing patients to bloating from being on a regular diet. This in turn compounds their appetite loss and leads to a further reduction in food intake.

Based on this, researchers from China's Zhengzhou University conducted a study to determine how ONS affects paediatric ALL patients who are undergoing remission-induction chemotherapy.

Onus on ONS

Between July 2013 and December 2015, they recruited from two paediatric wards 127 patients who had been diagnosed with the disease and who had been undergoing chemotherapy at the First Affiliated Hospital of Zhengzhou University.

One ward was randomly assigned to be the control group and the other the intervention group; children in both groups were matched for sex and age, with no significant difference in their pre-treatment baseline information.

The 60 children in the ONS group were given Peptamen, a peptide-based formula made for people unable to absorb or digest nutrients in conventional food, while the 67 children in the control group were placed on a low-fat diet.

33 days later

After 33 days, the researchers observed that post-chemotherapy weight loss among those in the control group was significantly higher than among those in the ONS group.

On the other hand, the children in the ONS group displayed significantly higher haemoglobin levels, as well as concentrations of total protein, albumin and pre-albumin.

In addition, the "incidences of hypoalbuminaemia, gastrointestinal complications, and infection were lower in the ONS group than in the control group".

In terms of the usage of hospital resources, the ONS group needed a lower amount of albumin infusion and fewer blood-product infusions, and as a result, incurred lower hospital costs than the control group.

Worth implementing

The researchers wrote that ONS did indeed improve the nutritional status of the children with ALL in remission-induction chemotherapy, lowering the incidence of complications and the costs of hospitalisation.

Therefore, they concluded: "ONS is beneficial for children undergoing chemotherapy and is especially necessary when children are at risk of nutritional deficiency."

 

Source: Asia Pacific Journal of Clinical Nutrition

https://doi.org/10.6133/apjcn.032017.04

"Benefit of oral nutritional supplements for children with acute lymphoblastic leukaemia during remission-induction chemotherapy: a quasi-experimental study"

Authors: Rui Liang, et al.