Is resting energy expenditure in children and adolescents (0-19 years) with cancer different to the general healthy population?

Abstract

1. Abstract: The determination of the energy requirements of paediatric oncology patients is of extreme importance, as children with cancer are at high risk of over and undernutrition. Changes in metabolic rate in children with cancer may contribute to malnutrition which has been associated with high morbidity and mortality rates. Understanding of energy expenditure of this population enables us to assess energy requirements appropriately and subsequently provide adequate nutrition support through cancer treatment. This literature review aimed to determine whether resting energy expenditure (REE) in children with cancer was increased, decreased or remained the same as the health status of the healthy population. We searched the PubMed, the Cochrane library and the online library of University College London for published studies that evaluated the changes in REE in paediatric patients who had hematological malignancy diseases or solid tumors or children who underwent hematopoietic stem cell transplant (HSCT). A limited number of studies have reviewed the changes in REE in children with cancer and reported wide variability in REE measurements. In our review, we observed a pattern of changes in REE based on the nature of cancer or type of HSCT. Our findings showed that REE in children with hematological malignancies showed either a reduction or no evidence of change. REE in children with solid tumours either increased or did not differ from the control group. Changes in REE in children undergoing HSCT varied according to the type of transplantation. We found that patients who had received an Allogenic HSCT showed the same results in three different studies – a reduction in REE in the first few weeks post-transplantation, followed by a gradual increase towards baseline during the time of recovery. In contrast, children who had received an Autologous HSCT presented either an increased REE or similar values to the control group.