Association between malnutrition and leucopenia in patients with osteosarcoma

Haixiao Wu; Shu Li; Yile Lin; Jun Wang; Vladimir P Chekhonin; Karl Peltzer; Vladimir P Baklaushev; Kirellos Said Abbas; Jin Zhang; Huiyang Li; Chao Zhang

doi:10.3389/fnut.2022.899501

Association between malnutrition and leucopenia in patients with osteosarcoma

Front Nutr. 2022 Jul 28:9:899501. doi: 10.3389/fnut.2022.899501. eCollection 2022.

Authors

Haixiao Wu^{1

2}, Shu Li^{2

3}, Yile Lin^{2

4}, Jun Wang^{2

5}, Vladimir P Chekhonin^{2

6}, Karl Peltzer^{2

7}, Vladimir P Baklaushev^{2

8}, Kirellos Said Abbas^{2

9}, Jin Zhang^{1

2}, Huiyang Li^{2

10}, Chao Zhang^{1

2}

Affiliations

¹ Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
² The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China.
³ School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
⁴ Department of Orthopaedic Surgery, Tianjin Medical University General Hospital, Tianjin, China.
⁵ Department of Oncology, Radiology and Nuclear Medicine, Medical Institute of Peoples' Friendship University of Russia, Moscow, Russia.
⁶ Department of Basic and Applied Neurobiology, Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russia.
⁷ Department of Psychology, University of the Free State, Bloemfontein, South Africa.
⁸ Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation, Moscow, Russia.
⁹ Faculty of Medicine, Alexandria University, Alexandria, Egypt.
¹⁰ Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China.

Abstract

Background and aim: Leucopenia (LP) greatly limits the efficacy of chemotherapy in osteosarcoma patients. This study aimed to evaluate the nutritional status of osteosarcoma patients before chemotherapy, assess the risk of LP during the perichemotherapy period, and explore the association between malnutrition and LP.

Materials and methods: This study retrospectively analyzed osteosarcoma patients treated in the Tianjin Medical University Cancer Institute and Hospital, China, between January 2009 and December 2020 according to the inclusion and exclusion criteria. Malnutrition in adolescents (5 to 19 years old) and adults (≥20 years old) was diagnosed using WHO AnthroPlus software (version 1.0.4) and Global Leadership initiative on Malnutrition (GLIM), respectively. According to the diagnostic criteria of LP in CTCAE 5.0, patients were divided into the LP group and the non-LP group.

Results: A total of 245 osteosarcoma patients were included. The incidence of malnutrition was 49.0%, and the incidence of LP was 51.8%. The incidence of malnutrition in adolescent patients was 53.1%, and their incidence of LP was 55.2%; the incidence of malnutrition in adult patients was 43.1%, and their incidence of LP was 47.1%. Logistic regression analysis showed that malnutrition before chemotherapy was an independent risk factor for the occurrence of LP after chemotherapy (OR = 6.85, 95% CI = 2.16-25.43; and OR = 35.03, 95% CI = 6.98-238.46 in mildly and severely malnourished young patients; OR = 6.06; 95% CI = 1.43-30.16; and OR = 38.09, 95% CI = 7.23-285.78 in mildly and severely malnourished adult patients, respectively). The results showed that age and nutritional status had a joint effect on the occurrence of LP.

Conclusion: The nutrition status of osteosarcoma patients before chemotherapy is significantly correlated with the occurrence and severity of LP during peri-chemotherapy period. During osteosarcoma chemotherapy, necessary nutritional support should be given to patients of different ages to correct their malnutrition status in a timely manner, ultimately improving the efficacy of chemotherapy and the prognosis of patients.

Keywords: chemotherapy; leucopenia; malnutrition; osteosarcoma; retrospective study.