The first cooperative study of the Asian Pacific bone marrow transplantation group included 75 patients with early leukemia who received human leukocyte antigen-matched sibling bone marrow transplants and were randomized into granulocyte colony-stimulating factor and control groups. The selected patients were registered from 10 centers in six countries and areas within Asia (Beijing, Taipei, Hong Kong, Japan, Korea, and Malaysia). The incidence of grades II-IV acute graft-vs.-host disease was 22.2%, and the 2-year survival rate was 62.7%. The period of protective isolation (27.1-66.7 days), period of hospitalization (38.6-130.5 days), and medical costs for 4 months (US $10,300-US $80,803) varied considerably. Good cooperation, i.e., low rate of protocol violation or rapid and precise presentation of case reports, was obtained.
INTRODUCTION: Malnutrition is common in cancer patients. Generally, it is believed that the resting energy expenditure (REE) is elevated in cancer patients and this contributes to the development of malnutrition. Thus, to be able to assess the REE is important in planning adequate nutrition support.
METHODS: A cross-sectional study was carried out to assess the REE in patients with solid tumour (n=25), leukemia (n=25) and healthy subjects (n=50) by using the indirect calorimetry method under standard conditions.
RESULTS: There was no significant difference between the measured REE among patients with solid tumour, leukemia and the control group (p=0.534). By contrast, there was a significant difference between the REE/kg FFM in solid tumour patients compared to the leukemia group and the healthy subjects, (p=0.049 and p=0.002). The REE derived from the Harris Benedict Equation was found to be significantly higher than the measured REE. The stress factor for patients with solid tumour was 1.35 and that for leukemia patients was 1.36.
CONCLUSION: The REE/kg FFM in the cancer patients undergoing anticancer therapy appeared to be higher than expected compared to healthy subjects. The Harris Benedict Equation (HBE) was found to over-estimate the REE of cancer patients in the study. As the total energy expenditure (TEE) is estimated by multiplying the REE with the stress factor and physical activity factor, the overestimated REE from HBE will further increase the risk of overfeeding in this population.