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A Multidisciplinary Review of Nutrition Considerations in the Pediatric Oncology Population: A Perspective From Children's Oncology Group

Elena J. Ladas, MS, RD^*, Nancy Sacks, MS, RD, Lillian Meacham, MD, Dave Henry, MS, BCOP, FASHP, Lori Enriquez, RD, CSP, CNSD, LDN^||, Genevieve Lowry, Med, CCLS^¶, Ria Hawkes, MS, CPNP^#, Gaye Dadd, RN, MN^** and Paul Rogers, MD, ChB

^* Division of Pediatric Oncology, Columbia University, Children's Hospital of New York, New York, New York; Department of Oncology, Children's Hospital of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics, Emory University and the AFLAC Cancer Center and Blood Disorders Services, Children's Healthcare of Atlanta, Atlanta, Georgia; Pharmacy Practice, University of Kansas Medical Center, Kansas City, Kansas;^|| The Children's Hospital of Philadelphia and Sodexho Healthcare Services, Department of Clinical Nutrition, Philadelphia, Pennsylvania; ^¶ Children's Hospital of New York Presbyterian, Division of Pediatric Oncology and^# Division of Hematology and Blood and Marrow Transplantation, Department of Child Life, New York, New York;^** Hematology/Oncology, Princess Margaret Hospital for Children, Perth, Western Australia; and the Division of Pediatric Hematology/Oncology/Blood and Marrow Transplantation, British Columbia Children's Hospital, Vancouver, British Columbia, Canada

Correspondence: Elena J. Ladas, MS, RD, Division of Pediatric Oncology, Columbia University Children's Hospital of New York, 161 Ft. Washington, Room 728, New York, NY 10032. Electronic mail may be sent to ejd14{at}columbia.edu.

Over the past few decades, great progress has been made in the survival rates of childhood cancer. As survival rates have improved, there has been an increased focus on supportive care. Nutrition is a supportive-care modality that has been associated with improved tolerance to chemotherapy, improved survival, increased quality of life, and decreased risk of infection in children undergoing anticancer therapy. Guidelines and assessment criteria have been proposed for the nutrition management of a child with cancer; however, there is no consistent use of criteria among institutions treating children with cancer. This review will present the current evidence and standards of practice incorporating aspects of nutrition, nursing, pharmacology, and psychosocial challenges to consider in the nutrition management of a child with cancer. Recommendations for clinical practice are presented.

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