Is serum albumin associated with prognostic in pediatric cancer patients?

Abstract

Serum albumin has been shown to be associated with clinical indicators in hospitalized patients. The objective was to study the association of serum albumin with clinical and nutritional indicators in pediatric cancer patients. A prospective cohort study carried out at Pediatric Oncology Institute of Federal University of São Paulo, Brazil. This study follows patients of 1 year old or above, during anti-cancer therapy, from January 2002 to January 2004, enrolled in an enteral nutritional protocol. Exclusion criteria were corticoid therapy, swallowing abnormalities and previous nutritional support. They received two types of oral supplement (industrialized formula and non-industrialized/homemade supplementation) and were followed for three weeks. Serum albumin was collected at admission of the nutritional protocol and after three weeks. The associations of the clinical and nutritional index with the decrease in serum albumin, serum albumin at admission and in week three and the differences between serum albumin in week zero and week three were studied. Fifty-four patients were analyzed. The analysis showed that episode of hospital stay and fever were associated with the decrease in serum albumin (p<0.05); and episode of hospital stay (p=0.05) and infection (p=0.02) with serum albumin in week three. Nutritional performance showed association with serum albumin: the higher albumin at admission of the protocol, the better nutritional outcome (p=0.02). Serum albumin at week three also influenced nutritional outcome: higher serum albumin was associated with reduced tube feeding indication (p=0.04). No association was found between serum albumin and anthropometric and body composition indexes. Albumin was more associated with clinical than nutritional index. This confirms adult studies that found association between albumin depletion and prognostic factors.