Preliminary data reveal some degree of nutritional depletion in up to 54% of newly diagnosed children with acute lymphoblastic leukemia in Guatemala. Deaths due to abandonment of therapy and treatment failure were more common in under-nourished than in well-nourished children when nutritional status was determined by arm anthropometry (mid upper arm circumference and triceps skin fold thickness). Given that these measures are less subject to variation between racial/ethnic groups than is the case with height and weight, it is recommended that arm anthropometry become part of the standard of care for children with cancer in developing countries. Pediatr Blood Cancer 2008;50:502–505. © 2007 Wiley-Liss, Inc.