Nutritional status of children with solid tumors.
BACKGROUND
The purposes of the study were to evaluate prospectively the nutritional status of children with solid tumors who were receiving chemotherapy, to find the most sensitive parameter of protein energy malnutrition, and to determine whether the stage of disease and aggressiveness of chemotherapy have any influence on nutritional status.


METHODS
Fifty patients were followed prospectively from the time of diagnosis throughout chemotherapy. Serum albumin, prealbumin, and weight were measured at the time of diagnosis and before each course of chemotherapy.


RESULTS
At diagnosis, only 2.7% of patients had albumin levels < 3.5 g/dL whereas 36% had prealbumin levels below the normal limit. All patients showed a weight increment of 81 g/day (P = 0.0001), an albumin increment of 0.001 U/day (P = 0.0001), and a prealbumin increment of 0.044 U/day (P = 0.0407). The change in prealbumin values was much more prominent (10-fold higher) in children age < 2 years. Changes in albumin values were not statistically significant by stage of disease but the increment of prealbumin did show statistical significance, which was most prominent in patients with Stage IV disease CCG (children's cancer group classification ) (P = 0.0003). The intensity of chemotherapy had no influence on changes in weight or albumin levels. However, it did influence changes in prealbumin levels, which were most pronounced in the group receiving high dose chemotherapy.


CONCLUSIONS
Based on the results of the current study, the authors believe prealbumin is the most powerful test overall with which to evaluate the nutritional status of children with solid tumors both at the time of diagnosis and throughout chemotherapy.
Elhasid
R
R
Department of Pediatric Hematology Oncology, Rambam Medical Center, Haifa, Israel.
Laor
A
A
Lischinsky
S
S
Postovsky
S
S
Weyl Ben Arush
M
M
D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D009752:Nutritional Status; D011228:Prealbumin / Q000032:analysis*; D011446:Prospective Studies; D011488:Protein Deficiency / Q000175:diagnosis / Q000209:etiology; D012709:Serum Albumin / Q000032:analysis*
D000970:Antineoplastic Agents; D011228:Prealbumin; D012709:Serum Albumin