mpact of Nutritional Status and WBC Count on Outcomes in Childhood Acute Lymphoblastic Leukemia Therapy

Background: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy worldwide. Prognostic factors, including nutritional status and white blood cell (WBC) count at diagnosis influence treatment outcomes. Malnutrition weakens immune function, leading to infections and treatment delays, whereas hyperleukocytosis is associated with a poor prognosis. Understanding these factors is important for optimizing treatment strategies. This study aimed to evaluate the impact of nutritional status and white blood cell (WBC) count on treatment outcomes in childhood ALL. Methods: This cross-sectional study was conducted at the Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from January to June 2013. Fifty children aged 1–15 years with newly diagnosed ALL, who received induction therapy, were included. Nutritional status was assessed using body mass index (BMI) (≥5 years) and weight-for-height (<5 years). WBC count was categorized as <50,000/mm³ and >50,000/mm³. Data were analyzed using SPSS, with statistical significance set at P <0.05. Results: Among the 50 patients, 62% were aged ≥5 years and 56% were male. Malnutrition was observed in 40% of the patients, and 66% had hyperleukocytosis (>50,000/mm³). Mortality was 100% among patients with WBC count >50,000/mm³. Malnourished children have prolonged neutropenia and higher infection rates with 10% mortality. Hyperleukocytosis was significantly associated with treatment failure and mortality (p<0.05). Conclusion: Nutritional status and WBC count were critical predictors of ALL treatment outcomes. Early nutritional interventions and risk-adapted treatment strategies can improve patient survival. A multidisciplinary approach is essential to improve patient outcomes.