Nutritional status of children undergoing treatment for ALL

• Research type

  Research Study

• Full title

  Nutritional status of children undergoing treatment for Acute Lymphoblastic Leukaemia: Longitudinal observational study

• IRAS ID

  334875

• Contact name

  Graeme O'Connor

• Contact email

  graeme.o'connor@gosh.nhs.uk

• Sponsor organisation

  Great Ormond Street Hospital

• Duration of Study in the UK

  3 years, 0 months, 0 days

• Research summary

  Acute lymphoblastic leukaemia (ALL) is a malignant transformation and proliferation of lymphoid progenitor cells in the bone marrow, blood and extramedullary sites. Dose intensification strategies have led to a significant improvement in outcomes for paediatric patients, contemporary childhood ALL studies have shown improved 5-year overall survival (OS) rates exceeding 90% (Pieters et al., 2016). Although the 5-year survival rate has significantly increased with improved intensive therapies, many of these survivors experience long-term adverse sequelae of their disease and its treatment. Three-in-four survivors of childhood ALL are at risk of developing chronic diseases such as obesity, type 2 diabetes, and cardiovascular diseases (Wang et al., 2020). Of note, overweight and obesity in ALL is an important prognostic indicator for relapse risk (Gelelete et al., 2011).

  The purpose of this study is to observe the impact of Acute Lymphoblastic Leukaemia (ALL) treatment regimens on the nutritional status of children. This will be the first large study to monitor body composition (4-lead bioelectrical impedance assessment), resting energy expenditure (indirect calorimetry) and biochemistry throughout the treatment period for ALL. This will provide information on the pathophysiological changes that leads to sarcopenic obesity – a reduction in skeletal muscle mass, increase in body fat and decrease resting energy expenditure. The nutritional intake with be monitored alongside the physiological and behavioural changes of corticosteroid ALL treatment that may further exacerbate the manifestation of sarcopenic obesity. Obesity increases the risk of relapse and therefore an undesirable outcome for ALL treatment. The study will also compare biochemical changes with body composition and dietary intake to ascertain the aetiology of lipidaemia in this cohort.

  Data obtained from this study may inform clinical guidelines to aid healthcare professionals to implement dietary and lifestyle advice to mitigate complications associated with ALL related sarcopenic obesity.

• REC name

  North of Scotland Research Ethics Committee 1

• REC reference

  24/NS/0023

• Date of REC Opinion

  14 Mar 2024

• REC opinion

  Further Information Favourable Opinion