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Change in energy and protein status during chemotherapy in patients with acute leukemia
Author(s) -
Lerebours Eric,
Tilly Herve,
Rimbert Agnes,
Delarue Jacques,
Piguet Hubert,
Colin Raymond
Publication year - 1988
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19880615)61:12<2412::aid-cncr2820611203>3.0.co;2-r
Subject(s) - medicine , chemotherapy , acute leukemia , resting energy expenditure , nitrogen balance , leukemia , gastroenterology , surgery , energy expenditure , nitrogen , physics , quantum mechanics
The energy and protein status of 12 adult patients with acute leukemia (AL) was investigated during induction chemotherapy. Parenteral nutrition (PN) (nonprotein [NP], 31.4 kcal/kg/d; nitrogen [N], 0.177 g/kg/d) was started on day 6 after the beginning of chemotherapy and continued through all of the cytopenic phase. A clinical and metabolic evaluation, including measurement of resting energy expenditure (REE) by indirect calorimetry, was performed on each patient within the 2 days before beginning chemotherapy (D0), on the third day of chemotherapy (D3), and then weekly from day 7 until the end of the cytopenic phase. Measured REE at day 0 (29.5 ± 1.4 kcal/kg/d) was significantly higher (+34 ± 6%) than theoretical REE. Chemotherapy induced a significant decrease in REE at day 3 (26.2 ± 1.7 kcal/kg/d; P < 0.05), but during the cytopenic phase REE was not different significantly from its initial values (D0). A positive energy balance was observed during the whole study after the beginning of PN. In contrast, mean nitrogen balance remained negative always, due to a sharp increase in urinary nitrogen loss during the cytopenic phase. The fact that nutritional support falls short of its goal may explain why no improvement in tumor response to therapy has been described in most studies.