O052 - BODY COMPOSITION AND THE RISK OF BLOODSTREAM INFECTIONS IN CHILDREN WITH CANCER

O052

BODY COMPOSITION AND THE RISK OF BLOODSTREAM INFECTIONS IN CHILDREN WITH CANCER

L. Renting^1,*, D. van der Vossen¹, D. Froon-Torenstra¹, M. Fiocco^1,2,3, A. Boot⁴, H. van Santen⁵, D. Kok⁶, W. Tissing^1,7, M. van den Brink¹

¹Princess Máxima Center for Pediatric Oncology, Utrecht, ²Mathematical Institute Leiden University, ³Medical Statistics, Department of Biomedical Data Science, Leiden University Medical Center, Leiden, ⁴Department of Pediatric Endocrinology, University Medical Center Groningen, Groningen, ⁵Department of Pediatric Endocrinology, Wilhelmina Kinderziekenhuis, Universitair Medisch Centrum Utrecht, Utrecht, ⁶Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, ⁷Department of Pediatric Oncology and Hematology, University Medical Center Groningen, Groningen, Netherlands

Rationale: Bloodstream infections (BSIs) are one of the most common and life-threatening side effects among children undergoing chemotherapy. Both low and high body mass index (BMI) have been identified as risk factors for BSIs, however, BMI does not distinguish between fat mass (FM) and fat-free mass (FFM). This study investigated the association between body composition and the risk of BSIs in children with cancer.  

Methods: Data were derived from a prospective cohort study among children aged 4-18 years diagnosed with cancer. Body composition was assessed approximately 3 months after cancer diagnosis using bioelectrical impedance analysis. Fat percentage (fat%), FM, and FFM were converted into standard deviation scores (SDS) using Dutch reference values. BSIs were identified from medical records and defined as the presence of bacterial or fungal microorganisms in the bloodstream. Multivariable Cox proportional hazards regression and negative binomial regression models were used to assess the association between body composition and the risk and number of BSIs, respectively. 

Results: A total of 85 patients were included (42% girls, median age 11 years), of whom 33 (39%) experienced at least one BSI. A higher fat% SDS was associated with a higher hazard of developing at least one BSI (HR=1.64, 95%CI=1.01-2.66). Both a higher fat% and FM SDS were associated with more BSIs during treatment (RR=2.23, 95%CI=1.30-3.80, and RR=2.29, 95%CI=1.35-3.90, respectively).

Conclusion: In the present study, higher fat% and FM were associated with an increased hazard of developing BSIs and a higher number of BSIs during chemotherapy treatment in children with cancer. These findings emphasize the importance of body composition assessments rather than relying solely on BMI in children with cancer. Future studies may focus on the prevention of excessive FM gain during treatment and its possible effect on reduction of BSIs in children with cancer. 

Disclosure of Interest: None declared