{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T06:57:17Z","timestamp":1781161037197,"version":"3.54.1"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Pediatr"],"published-print":{"date-parts":[[2026,5]]},"abstract":"\n Background:<\/jats:title>\n Acute Lymphoblastic Leukemia (ALL) is the most common pediatric cancer with a 5-year survival rate of 90% in High Income Countries (HICs), but in lower-to-middle-income countries (LMICs) survival rates fall below 60%. This is influenced by many factors; one of the major ones being malnutrition.<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n To ascertain the changes in and association of nutritional status in the treatment of pediatric ALL patients.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n This article investigated the association between nutritional status in patients receiving ALL treatment, and morbidity and mortality. This is a retrospective study for the period of May 2022 to April 2023 including a total of 332 patients.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n The study used WHO defined weight-for-age and height-for-age for patients from 1\u2009year of age up till the age of 5\u2009years old, and BMI for age for patients over the age of 5 to assess nutritional status. Various disease and treatment variables were analyzed with patients\u2019 nutritional statuses.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n From the sample, more than one-third of patients (38.5%) were malnourished with the majority of them being underweight or severely underweight. Wilcoxon signed-rank test for paired values showed a\n P<\/jats:italic>\n -value of .0177 (\n z<\/jats:italic>\n \u2009=\u20092.373) when used to compare patient weight at initial assessment and weight after intensive phase of treatment, indicating a significant change in weight between both timepoints. Nutritional status was significantly associated with the number of patients with positive bacterial cultures (\n P<\/jats:italic>\n \u2009=\u2009.01) and multiple hospital admissions (\n P<\/jats:italic>\n \u2009=\u2009.004), but was not significantly associated with mortality (\n P<\/jats:italic>\n \u2009>\u2009.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Nutritional status changed significantly after intensive phase of treatment. Malnutrition in ALL patients was significantly associated with bacterial infections, however, it was not significantly correlated to patient mortality. Future prospective studies with a longer study period should be planned to follow patients compromised nutrition to assess long term survival.<\/jats:p>\n <\/jats:sec>\n \n Registration:<\/jats:title>\n Not applicable.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/11795565261454801","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T06:08:16Z","timestamp":1781158096000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nutritional Status Changes During Pediatric Acute Lymphoblastic Leukemia Treatment: A Study from a Tertiary Care Hospital in Pakistan"],"prefix":"10.1177","volume":"20","author":[{"given":"Sadia","family":"Imran","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology & Oncology, Indus Hospital & Health Network, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6300-8961","authenticated-orcid":false,"given":"Namrita","family":"Rai","sequence":"additional","affiliation":[{"name":"University of Eastern Finland, Kuopio, Northern Savo, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malick Muhammed Sabih","family":"Masood","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology & Oncology, Indus Hospital & Health Network, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wasfa","family":"Farooq","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology & Oncology, Indus Hospital & Health Network, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kishwer","family":"Nadeem","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology & Oncology, Indus Hospital & Health Network, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2014.09.004"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(17)30052-2"},{"key":"e_1_3_3_4_2","doi-asserted-by":"crossref","unstructured":"Gupta S Howard SC Hunger SP et al. Treating childhood cancer in low- and middle-income countries. In: Gelband H Jha P Sankaranarayanan R Horton S eds. Cancer: Disease Control Priorities. Vol. 3. 3rd ed. The International Bank for Reconstruction and Development\/The World Bank; 2015:121-146. Accessed September 18 2023. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK343626\/","DOI":"10.1596\/978-1-4648-0349-9_ch7"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/10245332.2015.1101968"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/03008916221084740"},{"key":"e_1_3_3_7_2","unstructured":"World Health Organization (WHO). Fact sheets - malnutrition. 2024. Accessed November 3 2024. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/malnutrition"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.4103\/0019-509X.175838"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000000428"},{"issue":"3","key":"e_1_3_3_10_2","first-page":"710","article-title":"Role of nutrition in pediatric patients with cancer","volume":"15","author":"Pedretti L","year":"2023","unstructured":"Pedretti L, Massa S, Leardini D, et al. Role of nutrition in pediatric patients with cancer. Nutrition. 2023;15(3):710.","journal-title":"Nutrition"},{"issue":"11","key":"e_1_3_3_11_2","first-page":"4333","article-title":"The need for evidence based nutritional guidelines for pediatric acute lymphoblastic leukemia patients: acute and long-term following treatment","volume":"5","author":"Owens JL","year":"2013","unstructured":"Owens JL, Hanson SJ, McArthur JA, Mikhailov TA. The need for evidence based nutritional guidelines for pediatric acute lymphoblastic leukemia patients: acute and long-term following treatment. Nutrition. 2013;5(11):4333-4346.","journal-title":"Nutrition"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59061008"},{"key":"e_1_3_3_13_2","unstructured":"Pakistan. Global Hunger Index (GHI) - peer-reviewed annual publication designed to comprehensively measure and track hunger at the global regional and country levels. 2023. Accessed July 24 2024. https:\/\/www.globalhungerindex.org\/pakistan.html"},{"key":"e_1_3_3_14_2","unstructured":"World Health Organization. Guideline: Assessing and Managing Children at Primary Health-Care Facilities to Prevent Overweight and Obesity in the Context of the Double Burden of Malnutrition. World Health Organization; 2017. Accessed November 6 2023. https:\/\/iris.who.int\/handle\/10665\/259133"},{"key":"e_1_3_3_15_2","unstructured":"WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards: Length\/Height-for-Age Weight-for-Age Weight-for-Length Weight-for-Height and Body Mass Index-for-Age: Methods and Development. WHO; 2006. Accessed November 6 2023. https:\/\/www.who.int\/publications-detail-redirect\/924154693X"},{"key":"e_1_3_3_16_2","unstructured":"World Health Organization (WHO). Growth reference 5-19 years - BMI-for-age (5-19 years). 2007. Accessed November 6 2023. https:\/\/www.who.int\/tools\/growth-reference-data-for-5to19-years\/indicators\/bmi-for-age"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/01635581.2022.2152194"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2891-4-28"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijc.IJC_110_19"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2020.110937"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26590"}],"container-title":["Clinical Medicine Insights: Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795565261454801","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11795565261454801","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795565261454801","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T06:08:20Z","timestamp":1781158100000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11795565261454801"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":20,"alternative-id":["10.1177\/11795565261454801"],"URL":"https:\/\/doi.org\/10.1177\/11795565261454801","relation":{},"ISSN":["1179-5565","1179-5565"],"issn-type":[{"value":"1179-5565","type":"print"},{"value":"1179-5565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"article-number":"11795565261454801"}}