We read with interest the paper of Yu et al. [1], "Nutri-early diagnosis of malnutrition in pediatric cancer patients. tional Status of Children With Leukemia," which appeared in Medical and Pediatric Oncology, and contribute Yu et al. [1] reported that prealbumin is the most sensitive indicator of visceral protein status in leukemic this article with our local experience in a similar patient group.
patients. We found that absolute prealbumin levels were 19.4 Ϯ 7.2 mg/dl in the remission group and 14.8 Ϯ 5.1 Pediatric cancer patients represent a high-risk group for protein energy malnutrition [2]. Mild or marginal malnutri-mg/dl in the active disease group (Table I) (P Ͻ 0.05).
The mean relative prealbumin values (observed value/ tion must be identified to prevent the development of severe protein-energy malnutrition in pediatric cancer patients. expected value ϫ 100) were 74.3 Ϯ 29.1 in the remission group and 58.1 Ϯ 23.3 in the active disease group We evaluated the nutritional status and determined that the daily energy, protein, and micronutritient intake identified (P Ͻ 0.05). Children in the active disease group had lower prealbumin values compared to children in the remission mild or marginal malnutrition in 45 pediatric cancer patients (25 in remission, 20 newly diagnosed or relapsed). group, suggesting that the activity of disease may affect the nutritional state of the children with malignancy. In Ninety-five percent of patients consumed energy and 35.5% of them consumed protein less than the recom-our study group, 80.0% of patients with mild malnutrition had low relative prealbumin values, verifying that preal-mended dietary allowance (RDA). We showed that 36.7-84.6% of patients consumed various vitamins and 75.8-bumin is a reliable and sensitive indicator of mild and marginal malnutriton. According to anthropometric mea-89.1% consumed minerals less than the RDA.
Nutritional status was evaluated with anthropometric surements, 69.6% of patients with normal nutritional status had low prealbumin values. This finding suggests that measurements and biochemical indices [1,3]. According to the weight-for-height index, 23 of 45 children (51.1%) low prealbumin may be found before prealbumin values.
This finding suggests that low prealbumin may be found were determined as malnutriated: 23 (28.9%) showed advanced malnutrition, 5 (11.1%) moderate malnutrition, before malnutrition is detected by anthropometric measurements and low prealbumin values may indicate the and 4 (11.1%) mild malnutrition. In developed countries it has been estimated that malnutrition is seen in 8-32% necessary planning of nutritional intervention.
Nutritional support provided after malnutrition occurs of pediatric cancer patients. In Turkey there are various problems associated with educational status, traditional is intolerable because of insufficient intake and it is usually hard to cover up the deficiency. Therefore, it is important nutritional habits of families, and environmental conditions. Therefore, malnutrition continues to be a major to prevent malnutrition before it occurs. We observed that patients in normal nutritional status consumed only 52.7% problem in Turkey, although its frequency decreases [4]. In chronic diseases like cancer, risk of malnutrition is of recommended energy. This observation suggests that nutritional deficiency had occurred in our patients before mal-very high. With this study, in 51.1% of pediatric cancer patients, malnutrition according to the weight-for-height nutrition was detected by anthropometric measures.
We conclude that malnutrition is common in pediatric index was determined with a higher ratio than your study group.
cancer patients and prealbumin is a reliable and sensitive indicator of mild and marginal malnutrition. Determining Although in our study group malnutrition is commonly determined by weight-to-height ratios, serum albumin prealbumin values and assessing the deficiency of microand macronutrients before malnutrition is detected by levels of all children were found to be normal (Table I). However, serum albumin levels were lower in the active anthropometric measures suggest that nutritional problems may occur and it is necessary to plan nutritional disease group than in the remission group (P Ͻ 0.05). These results suggested that albumin was not a reliable intervention in pediatric cancer patients. indicator in the early diagnosis of malnutrition in pediatric cancer patients, but may reflect acute metabolic response Zafer Kurugo ¨l, MD Ayten Egemen, MD to active disease.
Transferrin levels were less than 200 mg/dl in 17.8% Department of Social Pediatrics Nazan C ¸etingu ¨l, MD of patients. Serum transferrin levels were not significantly different in the two groups (Table I). These results sug-Senay O ¨ztop, MD Department of Pediatric Oncology gested that transferrin was not a reliable indicator in the