Objective:

To analyze longitudinal changes in nutritional indicators (weight Z-score, BMI Z-score, serum albumin) in children with newly diagnosed AML during induction chemotherapy and their correlation with treatment outcomes.

Key Findings:

• Weight Z-score and BMI Z-score declined continuously from pre-induction to 15 days post-completion, followed by gradual recovery.
• Patients with severe weight Z-score decline had significantly lower remission rates (56.3%) and higher TRM (18.8%) compared to mild (88.5%) and moderate (75.0%) decline groups.
• Severe decline correlated with higher rates of gastrointestinal, hepatic, and infectious toxicities, and increased remission-phase mortality (12.5%).
• Weight Z-score decline > 1.0 and serum albumin decline > 10 g/L were identified as independent risk factors for poor outcomes.
• ROC analysis indicated strong predictive value of weight Z-score decline for various treatment toxicities and remission-phase mortality.

Interpretation:

The study indicates that changes in nutritional status during induction chemotherapy are significantly linked to treatment outcomes, highlighting the importance of dynamic nutritional monitoring as a predictor of complications and mortality.

Limitations:

• Retrospective design may introduce bias.
• Limited to a single institution's patient population.
• Potential confounding factors not fully accounted for.
• The study's timeframe may affect the generalizability of the findings.

Conclusion:

The findings support the need for dynamic nutritional monitoring and early intervention in pediatric AML patients undergoing chemotherapy.