Researchers looked at 132 children who received a new cancer treatment called CAR-T therapy to see how it affected their nutrition and weight. They found that most children lost a small amount of weight during treatment, but those who got help from nutrition specialists—like special drinks or feeding tubes—actually gained weight or lost less. The study shows that getting nutrition support early, before problems start, works better than waiting until kids are struggling to eat. This research suggests that nutrition care should be an important part of treating children with this type of cancer.

The Quick Take

  • What they studied: How children’s weight and nutrition changed during CAR-T cancer treatment, and whether special nutrition support (like protein drinks or feeding tubes) helped them stay healthier
  • Who participated: 132 children (about 2 out of 3 were boys) with an average age of 8 years who received CAR-T treatment at one hospital in London between 2015 and 2024
  • Key finding: Children who received nutrition support gained weight or lost less weight (gained 0.7% or lost only 1.6%) compared to those who didn’t get support (lost 1.6%). Kids who got nutrition help early did even better than those who started it later.
  • What it means for you: If a child in your family is getting CAR-T cancer treatment, working with a nutrition specialist from the start may help them stay stronger and healthier during treatment. This appears to be especially important for maintaining weight and overall health during this intense therapy.

The Research Details

Researchers looked back at medical records from 132 children who had received CAR-T treatment at one hospital over a 9-year period (2015-2024). They reviewed what happened to each child’s weight and what nutrition support they received during their hospital stay for treatment. They compared outcomes between children who got different types of nutrition help and those who didn’t get any.

The nutrition support options included: special high-protein drinks you can drink by mouth, feeding tubes that go through the nose or directly into the stomach to deliver nutrition, and intravenous nutrition (nutrition given through an IV when the stomach can’t handle food). Researchers measured how much weight children gained or lost and how long they stayed in the hospital.

This research approach is important because it shows what actually happens to real children during this treatment in a real hospital setting. By looking back at what doctors already did and what happened, researchers could see which approaches worked best without having to do a new experiment. This type of study is especially useful for rare treatments like CAR-T where it’s hard to study many patients at once.

This study looked at real patient records from one hospital, which means the information is accurate but only represents that one center’s experience. The study included all children treated there during the time period, which is good. However, because it’s from one hospital, results might be different at other hospitals with different practices. The study is recent (2024) and covers a long time period (9 years), which gives a good picture of how this treatment affects nutrition over time.

What the Results Show

On average, children lost about 1.8% of their body weight from the time they received the CAR-T treatment until they left the hospital. However, this weight loss was much smaller in children who received nutrition support. About 62% of the children (about 2 out of 3) needed some kind of nutrition help during their hospital stay.

Among children who got nutrition support, the most common types were: special protein drinks (45% of those getting support), feeding tubes (56% of those getting support), and IV nutrition (34% of those getting support). Most children who needed feeding tubes got a tube through the nose rather than a permanent tube in the stomach.

Children who received any nutrition support gained weight on average (+0.7%), while those who didn’t get support lost weight (-1.6%). This difference was statistically significant, meaning it’s unlikely to be just by chance. Even more importantly, children who started nutrition support very early (within the first three days after treatment) did much better than those who started it later: they gained 0.4% of their weight versus losing 3.3% for those who started later.

Children who started tube feeding early (within three days) gained 2.4% of their weight, while those who started it later lost 3.6%. This shows that early planning for tube feeding is very important. IV nutrition was used for an average of 23 days, mainly when children couldn’t tolerate food through a feeding tube. Interestingly, children who didn’t receive any nutrition support had shorter hospital stays (19 days versus 30 days for those who did), but this likely means they were healthier overall and didn’t need as much support, not that nutrition support made them stay longer.

This is one of the first studies to carefully look at how CAR-T treatment affects children’s nutrition. Previous research has shown that keeping good nutrition during cancer treatment helps kids do better overall, but very little was known specifically about CAR-T. This study confirms what doctors suspected: that nutrition support is important during this treatment and that starting it early works better than waiting until problems develop.

This study only looked at one hospital in London, so results might be different at other hospitals with different practices or in different countries. Because researchers looked back at records rather than planning a study in advance, they could only see what doctors happened to do, not test whether one approach is definitely better than another. The study doesn’t tell us whether the weight loss that did occur affected how well the cancer treatment worked or how the children felt. Some children may have had nutrition support for reasons not recorded in the medical records.

The Bottom Line

Children receiving CAR-T treatment should have a nutrition specialist involved from the start of treatment (HIGH confidence based on this study). Families should be prepared early for the possibility of needing a feeding tube, as children who started tube feeding early had much better weight outcomes (MODERATE-HIGH confidence). Special protein drinks should be offered early as a first step before moving to feeding tubes (MODERATE confidence). Regular monitoring of weight and nutrition status during treatment is important (HIGH confidence).

Parents and caregivers of children receiving CAR-T treatment should pay close attention to this research. Doctors and hospitals treating children with CAR-T should consider using these findings to improve their nutrition support programs. Children with other types of cancer treatment might also benefit from similar nutrition support, though this study only looked at CAR-T. This research is less relevant for adults receiving CAR-T, as their nutrition needs may be different.

Weight changes happened during the hospital stay for CAR-T treatment (typically a few weeks). Children who got early nutrition support showed better weight outcomes by the time they left the hospital. Long-term effects on overall health and cancer treatment success would need to be studied separately, but maintaining weight during treatment is generally considered important for recovery.

Want to Apply This Research?

  • Track daily weight (or weekly if daily is not possible) starting from the day of CAR-T infusion through discharge. Also track which nutrition supports are being used and when they started (within first 3 days or after). Note any changes in appetite or ability to eat regular food.
  • If a child is starting CAR-T treatment, work with the nutrition team to plan ahead for possible feeding support needs. Don’t wait until the child is losing weight or refusing food—start special nutrition drinks early and discuss feeding tube options before they become urgent. Keep a food and nutrition diary to share with the nutrition specialist.
  • Weekly check-ins with the nutrition specialist during treatment, tracking weight trends and adjusting nutrition support as needed. After discharge, continue monitoring weight for several weeks to ensure the child is recovering well nutritionally. Report any ongoing difficulty eating or weight loss to the medical team.

This research describes what happened in one hospital and should not replace personalized medical advice from your child’s cancer treatment team. Every child is different, and nutrition needs during CAR-T treatment should be determined by doctors and nutrition specialists who know your child’s specific situation. If your child is receiving or about to receive CAR-T treatment, discuss nutrition planning with your medical team. This information is educational and not a substitute for professional medical care.