Skeletal muscle wasting and protein-energy malnutrition in children with a newly diagnosed acute leukemia.

The changes in skeletal muscle mass of 14 children with newly diagnosed acute leukemia were studied during the first 24 weeks of antileukemia therapy. A muscle index was calculated from the femoral quadriceps muscle thickness, measured by using an ultrasound method, and from the body surface area. Serum albumin concentration was used as a biochemical indicator of protein status. Some children had muscle wasting before diagnosis. The highest degree of muscle wasting developed by 4 to 6 weeks with an average of 27% decrease of the muscle index. Because of simultaneous increase of adipose tissue (average, 33% at 6 weeks and 37% at 12 weeks), the relative body weight or the limb circumferences did not decrease. Muscle mass recovery occurred within the next 6 months. Our data emphasize that changes in the relative body weight or limb circumferences do not reveal nutritional protein depletion and muscle wasting that occurs in children with newly diagnosed acute leukemia.