Low levels of serum transport proteins indicate catabolic protein status during induction therapy for acute lymphoblastic leukemia.

Twelve children with newly diagnosed acute lymphoblastic leukemia (ALL) were followed during the first 24 weeks of induction and consolidation therapy. Twelve additional patients with other types of cancer, receiving no prednisone medication, served as a reference group. The serum total protein, albumin, transferrin, and prealbumin concentrations were measured at 0, 2, 4, 6-10, 16, and 24 weeks and used as biochemical indices of protein nutritional status. In all patients studied, serum albumin and prealbumin concentrations were low at diagnosis. Decreasing serum total protein and transferrin concentrations, stable low serum albumin, and increasing prealbumin levels were observed during the ALL induction therapy. In contrast, these protein levels remained stable in the children with other malignancies. By week 8 the patients with ALL had lower serum total protein, albumin, and transferrin than the children with other types of cancer. We conclude that the low levels of the serum transport proteins indicate catabolic protein status in children with ALL during early weeks of therapy.