Protein Turnover, Energy Expenditure and Body Composition in Patients with Acute Leukaemia Undergoing Chemotherapy

Abstract

1. Measurements of whole body protein turnover using the (13)C-leucine tracer technique, of body composition using anthropometric measurements and DEXA scanning, and of resting energy expenditure (REE) assessed by indirect calorimetry were made in 8 patients with acute leukaemia undergoing a single course of chemotherapy. Measurements were made in the post absorptive state immediately before chemotherapy and were repeated close to the time of discharge from hospital (mean days in hospital 31 ± 4.3, range 22-35), a mean of 23 ± 4.8 days after completion of chemotherapy. 2. The mean weight loss was 3.63kg (P < 0.001) with significant reductions in the mean non dominant mid arm circumference (1.29cm, P < 0.01), biceps (0.7mm, P < 0.01) and triceps (1.9mm, P < 0.05) skinfold thicknesses. DEXA scanning showed a reduction of mean body fat (1.22kg, P < 0.05) and lean tissue (1.85kg, P < 0.01). 3. There was a reduction in whole body leucine flux (Q) by 35% (P < 0.01) and synthesis (S) by 40% (P < 0.001) with no change in catabolism (C) over the course of admission. 4. There were no significant changes in REE.