Albumin Metabolism in Patients With Lymphoma

Abstract

Most patients with lymphoma have a reduced serum albumin concentration, often despite adequate nutrition and without evident liver disease or urinary protein loss (1-6). The etiology of this hypoalbuminemia is not clear. Possible causes include dilutional hypoalbuminemia, decreased albumin synthesis, increased albumin catabolism within the body, or excessive loss of albumin from the body through the kidneys or the gastrointestinal tract.

Low serum albumin is an independent risk factor in elderly patients with aggressive B‐cell lymphoma: Results from prospective trials of the German High‐Grade Non‐Hodgkin's Lymphoma Study Group

“…The literature is controversial about reduced albumin synthesis or degradation in cancer and lymphoma patients. Albumin is a negative acute phase protein; therefore, release of proinflammatory cytokines (eg, IL‐6, TNF) leads to reduced albumin synthesis in the liver and to hypoalbuminemia in cancer patients [ 6 , 7 ]. This finding is confirmed by an in vitro study in hepatocytes [ 31 ].…”

“…The degree of a perturbed albumin turnover in cancer or lymphoma patients is controversial. Two studies described impaired albumin synthesis with a normal survival in cancer including leukemia and lymphoma patients [ 6 , 7 ], whereas another group described normal albumin synthesis rates in cachectic individuals with pancreatic cancer [ 8 ]. In cancer patients, malnourishment and low serum albumin prior to anticancer therapy is a well‐established prognostic marker.…”

Abnormalities of Albumin Metabolism in Patients with Hypogammaglobulinemia*

“…Four had weight loss before this study, and all but one were underweight. Finally, other as yet undefined factors may be responsible for the defective albumin synthesis of the patients studied, since defective albumin synthesis is a common feature of chronic inflammatory diseases even when evidence of malabsorption or liver damage is lacking (24,25).…”

“…In the present study the serum albumin concentration was determined in 24 patients with impaired synthesis of gamma globulin. Twenty of these patients had significant hypoalbuminemia.…”

Η Μείωση Της Τιμής Της Ψευδοχολινεστεράσης Του Ορού Στη Διάγνωση Του Καρκίνου Του Πεπτικού Συστήματος

“…Υπάρχουν στοιχεία ότι στη νεοπλασματική καχεξία εμφανίζεται απώλεια των δομικών ηπατικών πρωτεϊνών 70 , αν και δεν έχει βρεθεί μείωση της πρωτεϊνοσυνθέσεως στο ήπαρ, αλλ' αντιθέτως αύξηση 23,52,β8 . Γεγονός παραμένει η υπολευκωματιναιμία των ασθενών με προχωρημένο καρκίνο, η οποία μπορεί ν' αποδοθεί σε αυξημένο καταβολισμό 71,72 , αλλά ίσως και σε μείωση της συνθέσεως των λευκωμάτων ή και σε απώλεια από τον ενδαγγειακό χώρο. Οπωσδήποτε, η συμπεριφορά των ηπατικών πρωτεϊνών στους καρκινοπαθείς δεν έχει ακόμα αποσαφηνισθεί .…”