Enteral nutrition for children with acute leukemia-related pancreatitis.

OBJECTIVE: Pancreatitis in children with acute lymphoblastic leukemia and acute myeloid leukemia may cause discontinuation of chemotherapy, thus adversely affecting treatment outcomes. Enteral nutrition (EN) is recommended for acute pancreatitis. The optimal use of EN for leukemia-related pancreatitis is under debate. The aim of this study was to determine the clinical efficacy of EN for children with leukemia-related pancreatitis.

METHODS: Medical records of 53 children with characteristics of leukemia-related pancreatitis were abstracted retrospectively. Considering specific outcome variables, the EN-associated factors improving treatment were analyzed. Enzyme and albumin changes during the 14-day follow-up period were also analyzed, to test for the safety of EN.

RESULTS: Early EN was found to be a protective factor from secondary infection and significant weight loss. Jejunal EN was related to higher risk for enzyme elevation relapse compared with oral EN. Patients with severe pancreatitis had lower risk for significant weight loss but higher risk for abnormal glucose levels than their counterparts. EN type had a significant effect on lipase change, and early EN had interactive effects by time on amylase and lipase changes.

CONCLUSIONS: Early EN within 7.5 days could reduce the risk for secondary infection and significant weight loss for pediatric leukemia-related pancreatitis, with decreased serum amylase and lipase levels, in a safe and effective manner. Beneficial effects of EN within 72 h were not observed.