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.