title: Longitudinal nutritional assessment in acute lymphoblastic leukemia during treatment.
abstract: BACKGROUND
  A nutritional assessment of pediatric patients with cancer is important to improve their outcome. The number of longitudinal nutritional studies during treatment, however, is limited. The purpose of this study was to investigate the longitudinal changes in anthropometric measures and serum albumin level during chemotherapy in patients with acute lymphoblastic leukemia (ALL).
  
  
  METHODS
  We retrospectively reviewed the charts of 23 patients (19 boys, four girls) with ALL from April 2007 to March 2010. The median age at diagnosis was 4.5 years. Bodyweight, height, and serum albumin levels were measured at the start and the end point of each chemotherapy phase.
  
  
  RESULTS
  At diagnosis, two patients (8.7%) were underweight and five patients (21.7%) were overweight according to body mass index z-score, while five patients were underweight and three (13.0%) were overweight according to Waterlow score. The prevalence of malnourished patients did not change significantly throughout chemotherapy by either assessment. The absolute scores in either assessment were significantly reduced at the sanctuary treatment phase. Low serum albumin (<3.2 g/dL) was found in two patients at diagnosis. Mean albumin decreased significantly at the induction and the re-induction phases.
  
  
  CONCLUSIONS
  Given that nutritional status under a similar chemotherapeutic regimen as assessed by anthropometric measures and albumin level differed among patients, careful observation of the nutritional status and intervention may be necessary at different phases of chemotherapy.
authors.affiliation: Faculty of Human Life and Environment, Nara Women's University, Nara, Japan.
authors.forename: Yukie
authors.initials: Y
authors.lastname: Higashiyama
authors.forename: Chiaki
authors.initials: C
authors.lastname: Kojima
authors.forename: Masaru
authors.initials: M
authors.lastname: Kubota
authors.forename: Ayako
authors.initials: A
authors.lastname: Nagai
authors.forename: Ken-Ichiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Souichi
authors.initials: S
authors.lastname: Adachi
authors.forename: Ikuya
authors.initials: I
authors.lastname: Usami
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D015596:Nutrition Assessment; D009752:Nutritional Status; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000503:physiopathology; D012189:Retrospective Studies
keywords: Waterlow score; acute lymphoblastic leukemia; albumin; body mass index z-score; chemotherapy; nutritional assessment