PP-043 The Relationship Between Serum Albumin Level and Non-dipper pattern in Newly Diagnosed Hypertension Patients

Background: Adequate nutrition is an important concern in children with leukemia. Malnutrition and weight lost are common and are due to verity of mechanism involving the tumor, the host response to the tumor such as infection and pharmacokinetics of chemotherapeutic drugs. Objective: To evaluate and compare the nutritional status of children with ALL at diagnosis and after completion of induction therapy. Methodology: This prospective observational study included 60 children newly diagnosed as ALL, aged 2-15 years, over a period from April 2012 to September 2012 in the Department of Pediatric Hematology and Oncology, BSMMU. The anthropometric measurements and serum albumin level were taken. Anthropometric indices are calculated by NCHS (WHO-2000) and classified as Z score. Children <-2 SD are considered as underweight (WFA), stunted (HFA) and wasted (WFH). Serum albumin level below 21g/dl is considered as severely malnourished. The Hb values of the children are compared with normal values by age. The children got induction chemotherapy according to MRC-11 protocol. They were in regular follow up and again anthropometric measurements and serum albumin level were taken after completion of induction. Results: Out of 60 children with ALL, 48 (70%) were underweight, 45 (75%) were stunted 36 (60%) were wasted at diagnosis. Incidence of malnutrition among leukemia children after completion of induction were 24 (40%) underweight, 45 (75%) were stunted and 6 (10%) were wasted. The results showed that children in the newly diagnosed stage had a higher prevalence of malnutrition. However no statistically significant difference in the nutritional status was found among newly diagnosed and after completion of induction in term of underweight and stunting but newly diagnosed patients had statistically significant wasting than patients who had completed induction chemotherapy. No patient showed severe malnutrition based on the cut-off point for serum albumin on both stages. All the children (100%) had less than normal range hemoglobin levels. Conclusion: Malnutrition was higher in children with newly diagnosed leukemia. Children had significant differences in the nutritional status in term of wasting at diagnosis than after completion of induction therapy. So, the nutritional status of children with leukemia should be monitor periodically.

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536: THE RELATIONSHIP BETWEEN SERUM ALBUMIN LEVEL AND ORGAN DYSFUNCTION AFTER LIVER TRANSPLANTATION

Critical Care Medicine ◽

10.1097/01.ccm.0000528554.09418.01 ◽

2018 ◽

Vol 46 (1) ◽

pp. 253-253

Author(s):

Hiroi Kazumasas ◽

Takashi Matsusaki ◽

Ryuji Kaku ◽

Hiroshi Morimatsu

Keyword(s):

Liver Transplantation ◽

Serum Albumin ◽

Organ Dysfunction ◽

Serum Albumin Level ◽

Albumin Level ◽

The Relationship

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Albumin Is a Prognostic Factor for Overall Survival in Newly Diagnosed Patients with Acute Myeloid Leukemia (AML)

Blood ◽

10.1182/blood.v118.21.4253.4253 ◽

2011 ◽

Vol 118 (21) ◽

pp. 4253-4253

Author(s):

Awais M. Khan ◽

Jeffrey E. Lancet ◽

Mohamed A. Kharfan-Dabaja ◽

Najla H Al Ali ◽

Alan F. List ◽

...

Keyword(s):

Overall Survival ◽

Serum Albumin ◽

Induction Chemotherapy ◽

Serum Albumin Level ◽

Cox Regression ◽

Albumin Level ◽

Normal Serum ◽

Newly Diagnosed ◽

Kaplan Meier ◽

History Of

Abstract Abstract 4253 Background: Hypoalbuminemia (HA) is a strong predictor of poor clinical outcomes in many medical conditions. Low serum albumin is recognized as an adverse prognostic factor in patients with neoplastic diseases such as multiple myeloma, melanoma, and colon cancer. Severe hypoalbuminemia (<3.0 g/dl) at day +90 post allogeneic hematopoietic cell transplant (AHCT) was reported as an independent predictive variable for non-relapse mortality and overall survival (Kharfan-Dabaja, et al Biol Blood Marrow Transplant 2009; 15). A separate study conducted by our group showed that in patients with relapsed and refractory AML, serum albumin < 3.5 g/dl prior to salvage chemotherapy, correlated with lower complete remission (CR) rate and inferior overall survival (OS) (Komrokji, et al ASH 2009). We examined the prognostic value of serum albumin level prior to induction chemotherapy in patients with newly diagnosed AML. Methods: Data were collected retrospectively in a cohort of newly diagnosed AML patients who received induction chemotherapy (3+ 7 regimen). The primary objective of this study is to examine the relationship between serum albumin at baseline and probability for achieving complete remission (CR) or incomplete remission (CRi) and overall survival (OS). All analyses were conducted using SPSS version 19.0. The Kaplan–Meier method was used to estimate median overall survival; chi-square test was used for comparison of categorical variables and t-test for continuous variables. Log rank test was used to compare Kaplan–Meier survival estimates between two groups and Cox regression for multivariable analysis. Results: Between November 2004 and July 2007, 135 patients who received 3+7 induction chemotherapy at Moffitt Cancer Center were included in this analysis. Patient baseline characteristics were similar between patients with baseline serum albumin < 3.5 g/dl (HA) and those with serum albumin ≥ 3.5 g/dl (no HA) with respect to age, sex, FAB subtype, history of antecedent MDS, karyotype, and chemotherapy. Patients with HA, mean age was 60 years compared to 56.5 years in non HA group. The median OS for patients with HA was 221 days (95%CI 149.5–292.5) compared to 421 days (95%CI 236.7–605) with normal serum albumin (p<0.005). (Figure-1) The CR/CRi rate was 64%% for HA and 77.6% for those with normal albumin (p=0.09). In a multivariable Cox regression analysis including age ≥ 60 years, history of MDS, karyotype, and serum albumin level at baseline; only age, karyotype and serum albumin were independent predictors of OS [Hazard ratio 0.47 (95%CI 0.31–0.71) (p<0.005) for normal serum albumin group]. Conclusion: In this cohort of patients with newly diagnosed AML, we demonstrate that hypoalbuminemia < 3.5 g/dl is an independent covariate for overall survival with conventional chemotherapy management. Serum albumin is a surrogate marker of general health, comorbidities, and performance status. The prognostic value of low serum albumin should be validated in a prospective study. Disclosures: No relevant conflicts of interest to declare.

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The Relationship of Serum Albumin Level to Phenytoin Toxicity

The Journal of Clinical Pharmacology ◽

10.1002/j.1552-4604.1987.tb02194.x ◽

1987 ◽

Vol 27 (3) ◽

pp. 249-250 ◽

Cited By ~ 2

Author(s):

Jimmy Black ◽

Tony Hannaman ◽

Christine Malone

Keyword(s):

Serum Albumin ◽

Serum Albumin Level ◽

Albumin Level ◽

Relationship Of ◽

The Relationship ◽

Phenytoin Toxicity

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Albumin as a prognostic factor for overall survival in newly diagnosed patients with acute myeloid leukemia (AML).

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.6586 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 6586-6586

Author(s):

Awais M. Khan ◽

Jeffrey E. Lancet ◽

Mohamed A. Kharfan-Dabaja ◽

Najla Al Ali ◽

Alan F. List ◽

...

Keyword(s):

Overall Survival ◽

Serum Albumin ◽

Induction Chemotherapy ◽

Prognostic Value ◽

Serum Albumin Level ◽

Albumin Level ◽

Normal Serum ◽

Newly Diagnosed ◽

Kaplan Meier ◽

History Of

6586 Background: Hypoalbuminemia (HA) is an adverse prognostic factor in multiple neoplastic diseases. Severe hypoalbuminemia (<3.0 g/dl) at day +90 post allogeneic hematopoietic cell transplant (AHCT) was reported as an independent predictive variable for non-relapse mortality and overall survival (Kharfan-Dabaja, et al Biol Blood Marrow Transplant 2009; 15). We examined the prognostic value of serum albumin level prior to induction chemotherapy in patients with newly diagnosed AML. Methods: Data were collected retrospectively in newly diagnosed AML patients receiving induction chemotherapy (3+ 7 regimen). Primary objective was to examine the relationship between serum albumin at baseline and probability of achieving complete remission (CR) or incomplete remission (CRi) and overall survival (OS). The Kaplan–Meier method used to estimate median overall survival; chi-square test used for comparison of categorical variables and t-test for continuous variables. Log rank test used to compare Kaplan–Meier survival estimates between two groups. Results: Between November 2004 to July 2007, 135 patients who received 3+7 induction chemotherapy were included. Patient baseline characteristics were similar between patients with serum albumin < 3.5 g/dl (HA) and those with serum albumin ≥ 3.5 g/dl (no HA) with respect to age, sex, FAB subtype, history of antecedent MDS, karyotype, and chemotherapy . In patients with HA, mean age was 60 years compared to 56.5 years in non HA group. The median OS for patients with HA was 221 days (95%CI 149.5-292.5) compared to 421 days (95%CI 236.7-605) with normal serum albumin (p<0.005). (Figure-1) The CR/CRi rate was 64%% for HA and 77.6% for those with normal albumin (p=0.09). In a multivariable Cox regression analysis including age ≥ 60 years, history of MDS, karyotype, and serum albumin level at baseline; only age, karyotype and serum albumin were independent predictors of OS [Hazard ratio 0.47 (95%CI 0.31-0.71) (p<0.005) for normal serum albumin group]. Conclusions: In newly diagnosed AML, we demonstrate that hypoalbuminemia < 3.5 g/dl is an independent covariate for overall survival with conventional chemotherapy management. The prognostic value of low serum albumin should be validated in a prospective study.

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Residual Renal Function in a Large Cohort of Peritoneal Dialysis Patients: Change over Time, Impact on Mortality and Nutrition

Peritoneal Dialysis International ◽

10.1177/089686080002000411 ◽

2000 ◽

Vol 20 (4) ◽

pp. 439-444 ◽

Cited By ~ 51

Author(s):

Douglas Shemin ◽

Andrew G. Bostom ◽

Cynthia Lambert ◽

Connie Hill ◽

Jenny Kitsen ◽

...

Keyword(s):

Renal Function ◽

Serum Albumin ◽

Serum Albumin Level ◽

Renal Dialysis ◽

Residual Renal Function ◽

Albumin Level ◽

The Mean ◽

The Relationship ◽

Over Time ◽

Solute Clearance

Objective Residual renal function contributes importantly to total solute clearance in peritoneal dialysis (PD) patients. This study was designed to examine the progression of residual renal function over time and its impact on nutrition and mortality in PD patients in the six New England states (ME, NH, VT, CT, MA, RI) comprising End Stage Renal Disease (ESRD) Network 1. Design As part of the ESRD Clinical Indicators Project, data on 990 PD patients in Network 1 were abstracted from data supplied by dialysis units in the fourth quarter of 1997. This included demographic information; dose of PD in L/day; weekly renal, dialysis, and total Kt/V urea; weekly renal, dialysis, and total creatinine clearance (CCr); serum albumin level; and mortality and transplantation information. Data collection was repeated in the second and fourth quarters of 1998 and in the second quarter of 1999. Patients 990 PD patients in Network 1. Outcome Measures The change in total and renal solute clearances over time, the relationship between renal clearance and mortality, and the relationship between renal clearance and nutritional status, as represented by serum albumin. Results Over the 2-year period, mean weekly renal Kt/V urea and weekly renal CCr dropped significantly. To examine the effect of residual renal function on mortality, patients were divided into high and low (above and below the median) weekly renal Kt/V urea and weekly renal CCr groups. Patients above the median levels of both weekly renal Kt/V urea and weekly renal CCr had a significantly decreased risk of dying during the observation period, after controlling for age, gender, serum albumin level, and diabetic status [OR for high vs low renal Kt/V urea 0.54 (CI 0.34 – 0.84), OR for high vs low renal CCr 0.61 (CI 0.40 – 0.94)]. The mean weekly renal Kt/V urea was significantly and directly correlated with the mean serum albumin level by Spearman rank correlation ( R = 0.133, p < 0.001), as was the mean weekly renal CCr ( R = 0.115, p < 0.001). Conclusions Residual renal function is an important contributor to total solute clearance in PD patients. Even at low levels it is linked to decreased mortality and better nutritional status.

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