Introduction: Acute Lymphocytic Leukemia (ALL) therapy, particularly the intensive use of glucocorticoids, is strongly associated with adverse nutritional outcomes. This study aimed to investigate the changes in nutritional status, assessed by body mass index (BMI) and weight-for-height (WFH), during the first six months of treatment in children with ALL and to identify associated patient characteristics. Methods: A retrospective cohort study enrolled 325 pediatric ALL patients. Nutritional status was determined at diagnosis and after six months of standard therapy, using WFH for patients<2 years (n=83) and BMI for those≥2 years (n=242). Baseline demographics, initial white blood cell (WBC) count, CNS involvement, and corticosteroid type were analyzed using the Chi-square test for association with post-treatment nutritional status. Results: The cohort included 54.5% female patients. A rapid shift toward overnutrition was observed across all age groups. In the≥2-year-old cohort, the combined prevalence of overweight and obesity increased from 7.5% at diagnosis to 18.6 % at six months, while the underweight prevalence simultaneously decreased from 64.5% to 45.9%. Bivariate analysis revealed two significant risk factors for developing overweight/obesity: female gender (P=0.002) and a high baseline WBC count≥10/uL; P=0.006). No significant association was found between nutritional status and CNS involvement (P=0.486) or the specific corticosteroid agent used (P=0.632). Conclusion: The initial 6-month period of ALL treatment is a critical window for the rapid development of overnutrition, driven primarily by the class of glucocorticoids used. Female gender and a high baseline WBC count are crucial, easily identifiable metabolic risk markers that necessitate the implementation of early, targeted nutritional intervention strategies beginning at diagnosis.
Sabonchi et al. (Wed,) studied this question.