Nutritional Assessment of Leukemic Children and its Relationship with serum Selenium, Zinc and Copper

Abstract

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer and accounts for 30 – 35% of all cancers in children. Only 50 years ago, the disease was uniformly fatal with an Overall Survival (OS) rate < 5%. In modern day, multi-drug chemotherapy is associated with an overall survival rate over 80%. When undergoing chemotherapy and/or radiotherapy, children with ALL may present important nutritional disorders because of the gastrointestinal toxicity of most chemotherapy agents or the effects of radiation on the organism. These patients may also present changes in their serum concentrations of trace elements such as zinc and copper. The present study aimed to follow anthropometric parameters and serum levels of zinc and copper in a group of children in Bangladesh suffering from ALL before chemotherapy in age, sex and related differences.

A case-control study on 101 children with ALL and 121 children without any cancer or chronic diseases as control subjects were conducted. Anthropometric parameters such as weight and height and the daily intakes were recorded at diagnosis, and serum levels of copper and zinc were analyzed afterwards. Serum albumin, total protein, Ca++, ALT & LDH levels were analyzed by spectrophotometer. The trace elements Zn

were analyzed by atomic absorption spectroscopy.

Though Serum Ca + was normal the Cu

VII 2+ and Zn 2+ showed significantly (p<0.001, respectively) higher levels in ALL. There was significant difference in age between 1 to 5 years than control group (p <0.01). There were more male children than female between the two groups: 69.3% of cases versus 56.2% of controls were male. The difference in levels found between the groups may be associated with factors such as stage of disease, diet and drugs associated with treatment. The serum albumin was significantly lower compared to control (p <0.05). The serum ALT (p<0.001), and LDH (p <0.001), were significantly higher among ALL children compared to control while serum calcium (p>0.05) level was non-significantly normal when compared to control.