INTRODUCTION
Nutritional status is an independent prognostic factor for patients with
pediatric cancers, being underweight or overweight do affect
outcomes1,2. Micronutrient deficiency may occur in the
absence of macronutrient malnutrition. Micronutrients are vitamins,
minerals, and trace elements essential for optimal physiological
functioning and overall health3. Micronutrient levels
can range from excess, to normal range, to insufficiency to a definite
deficiency. Deficiency can sometimes be recognized at clinical
examination, e.g., rickets due to vitamin D deficiency.
The function of micronutrients and the effects of deficiency or excess
levels are well-documented ,3 Several studies in the
general pediatric population have documented that many children are
deficient in numerous micronutrients, which can result in specific
clinical pathology.3 Micronutrient deficiency may
affect event-free survival and exacerbate chemotherapy toxicity and
adverse events.4,5,6 We have conducted a feasibility
study by measuring six micronutrient levels at diagnosis and after six
months of chemotherapy. Fat-soluble vitamins A, D and E and trace
elements Copper (Cu), Selenium (Se) and Zinc (Zn) were evaluated.
We hypothesized that the micronutrients are deficient at diagnosis, may
remain so during chemotherapy, could potentially exacerbate the side
effects of chemotherapy, and may affect event-free survival.