Changes in Nutritional Status and Body Composition Among Children Undergoing Treatment for ALL in Guatemala.

Authors

Jessica Blanco-Lopez, Paulina Ubico, Sofia Leonardo, Erika Damasco-Avila, Troy Farncombe, Marisabel Perez, Gerson Morales, Ana L Molina, Federico Antillon-Klussmann, Ronald D Barr, Elena J Ladas

Published in

JCO global oncology. Volume 12. Issue 11. Pages e2600215. Epub Nov 12, 2026.

Abstract

Treatment for childhood ALL has been associated with sarcopenia and obesity in high-income countries (HIC); however, little is known about how treatment affects body composition or clinical outcomes for children receiving therapy outside HIC settings.
In this prospective study, 60 children with ALL were followed from diagnosis through the first 6 months of therapy. Assessments included anthropometrics (BMI for age [BMI/a]) and body composition (dual-energy x-ray absorptiometry to derive appendicular lean mass index [ALMI] and fat mass index [FMI]), and clinical outcomes. Longitudinal changes in ALMI and FMI Z-scores were assessed using multivariable linear mixed-effects models.
The cohort was 56.7% female with a mean age of 10.2 ± 4.6 years; 26.7% were malnourished at diagnosis. BMI/a did not increase significantly over time. ALMI decreased significantly from diagnosis to month 6, whereas FMI increased significantly. Sarcopenia rose from 40% at diagnosis to 66.1% by the end of induction. No evidence of sarcopenic obesity was observed. Higher ALMI and FMI were each significantly associated with severe adverse events, whereas higher FMI was further associated with treatment delays and fewer hospital days. No association of nutritional status and survival was observed.
Children with ALL in Guatemala exhibited distinct BMI/a trajectories compared with those reported in HIC, highlighting the influence of geographic, socioeconomic, and population-specific factors on treatment-related nutritional outcomes. Our findings may be beneficial in global settings where children of non-European ancestry represent a substantial proportion of patients. Further investigation is warranted to elucidate the underlying biological and contextual mechanisms and to inform context-appropriate nutrition interventions.

PMID:
43019497
Bibliographic data and abstract were imported from PubMed on 13 Nov 2026.

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