Nutrition and acute leukemia in adults: relation between nutritional status and infectious complications during remission induction.

Abstract

The purpose of this study was to determine whether nutritional state was related to infectious complications in adult patients with acute leukemia. During first-remission induction therapy (mean, 71 days), the duration of neutropenia, various infections, and fevers were related to changes in body weight and serum albumin concentrations as well as total parenteral nutrition (TPN) in 52 patients receiving standardized anti-infectious treatment. Severe neutropenia prevailed for 27% and fever for 28% of the induction period. A mean weight loss of 5.1 kg, corresponding to a reduction of body mass index from 23.5 to 21.7, was correlated with the number of days that patients had fever (P = 0.026). Despite a normal serum albumin value at the time of admission, patients had severe hypoalbuminemia (<25 g/L) during 16% of the induction period. The drop in serum albumin was independently related to the weight loss (r = 0.37, P = 0.03). Moreover, the incidence and duration of hypoalbuminemia were significantly correlated with duration of fever (P < 0.0001), diarrhea (P = 0.03), and TPN administration (P = 0.00002). Weight loss and severe hypoalbuminemia were common during remission induction for these adult patients with acute leukemia and were closely related to the patients' infections.