Background: Early nutrition assessment and intervention is recommended for patients with acute leukaemia receiving high dose chemotherapy.
Aim: To determine the prevalence of malnutrition and describe nutrition interventions in acute leukaemia patients admitted for induction chemotherapy.
Methods: Newly diagnosed leukaemia patients receiving inpatient induction chemotherapy at a tertiary hospital were eligible for inclusion. Retrospective data were collected on nutrition status and nutrition interventions from electronic medical records from January - December 2023.
Results: Seventy-two patients (53% male (n=38), median [IQR] age 62 [46-69] years) were included. The most common induction treatments included 7+3 (Cytarabine and Idarubicin) (31%, n=22), followed by Venetoclax/Azacytidine (22%, n=16). Overall, 71% (n=51) of patients lost weight (median [IQR] weight loss 3.4 [0-6.6] %). Forty patients were referred to the Dietitian a median [IQR] 8.5 [3-18] days after admission. Of these 24 patients (60%) had a Subjective Global Assessment completed to determine nutrition status. Eleven patients (46%) were malnourished on admission. Two patients were diagnosed with hospital acquired malnutrition during admission. Thirty-five patients received oral nutrition supplements, 14 received total parenteral nutrition and one patient received enteral nutrition, with some requiring multiple therapies. 91% of patients (n=20) who received 7+3 therapy were referred to the Dietitian a median [IQR] of 8.5 [3.3-16.8] days into admission, median [IQR] loss of weight was 4.6 [3-9.4] %.
Conclusion: Pre-existing malnutrition is common and may worsen in this patient cohort despite nutrition intervention. Results will inform a model of care to ensure timely nutrition assessment and intervention.
Acknowledgments: Jenny Chen, Clinical Nurse Consultant - Acute Leukaemia. Peter MacCallum Cancer Centre and The Royal Melbourne Hospital – Haematology and Bone Marrow Transplant.