ABSTRACT
Despite advancements in the knowledge, biology, and treatment of acute leukemias, in many countries, they represent the leading cause of disease-related deaths during childhood. Deaths mainly are due to a relapse, disease progression, and/or because of treatment-related complications such as infections, bleeding, and specific organ toxicity. Children with leukemia are particularly vulnerable to malnutrition, due to their high nutrient disease requirements, for their treatment and at the same time for growth and development needs. Undernutrition is a negative prognostic factor in children with leukemia; it is associated with an increase in morbidity and a decrease in disease-free survival (DFS), due to the development of severe infections, hemorrhages, and increased risk of treatment abandonment. Multiple causes trigger alteration in the nutritional status of children with end-stage leukemia. The most important is the anorexia-cachexia syndrome, which leads to metabolic alterations, with loss of muscle mass, fat mass, anemia, and deterioration of the general state that can be the direct cause of death. Therefore, nutritional support (NS) is essential to provide physiological requirements and also for the social, cultural, and psychological benefits and well-being of the patient.
