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All Journal International Journal of Integrated Health Sciences Indonesian Journal of Kidney and Hypertension Indonesian Journal of Cancer
Agustini, Made Priska Arya
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Predictive Factors of Neutropenia Following First Cycle of Chemotherapy in Patients with Non-Hodgkin’s Lymphoma in Bali, Indonesia Pratiwi, Made Sindy Astri; Agustini, Made Priska Arya; Yani, Made Violin Weda; Rena, Ni Made Renny Anggreni
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4178

Abstract

Background: Chemotherapy-induced neutropenia (CIN) is a common hematologic toxicity that increases infection risk, hospitalization, and treatment delay. Limited data exist on predictive factors of CIN among non-Hodgkin’s lymphoma (NHL) patients in Indonesia, particularly in Bali.Objective: To identify predictive factors of neutropenia following the first cycle of chemotherapy in patients with NHL at Prof. I.G.N.G Ngoerah General Hospital, Bali, Indonesia.Methods: This retrospective cohort study included all NHL patients treated from 2020–2023. Eligible patients were aged ≥18 years, received CHOP-based regimens with or without rituximab, and did not receive G-CSF prophylaxis. Data were obtained from medical records. Assessed risk factors were age, gender, BMI, comorbidities, histopathology grading, extranodal involvement, ECOG status, Ann Arbor stage, IPI score, chemotherapy regimen, pre-treatment blood count, eGFR, LDH, and albumin. The incidence of neutropenia was evaluated after the first chemotherapy cycle.Results: The mean age of the eligible patients (n=112) was 54.53 ± 14.64 years; 46 of them (41%) developed neutropenia. Significant factors associated with neutropenia were histopathology grading (p = 0.030), Ann Arbor stage (p = 0.048), IPI score (p = 0.037), chemotherapy regimen (p = 0.019), and LDH above normal (p = 0.049). Multivariate analysis identified high IPI scores (p = 0.016; OR 6.375; 95% CI 1.416–28.698) and CHOP regimen (p = 0.016; OR 3.033; 95% CI 1.230–7.476) as independent predictors of CIN.Conclusion: High IPI scores and CHOP regimens are strong predictors of neutropenia after the first chemotherapy cycle in NHL patients. Early identification of high-risk patients is essential for preventive management and improved treatment outcomes.
Factors Associated with Mortality of B-cell Non-Hodgkin Lymphoma Patients at Tertiary Care Hospital in Bali, Indonesia Agustini, Made Priska Arya; Pratiwi, Made Sindy Astri; Yani, Made Violin Weda; Rena, Made Renny Anggreni
Indonesian Journal of Cancer Vol 19, No 4 (2025): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i4.1359

Abstract

Background: Non-Hodgkin Lymphoma (NHL) incidence has increased rapidly in recent decades. Although new treatment methods have been found, the mortality rate of NHL, especially in developing countries, is still high. Several factors can affect the mortality rate of NHL. However, data on factors related to the mortality rate of NHL patients in Bali are still not available. Therefore, this study aims to determine the survival rate and prognostic factors of mortality in NHL patients, especially those with the B-cell type, in Bali.Method: This study is a retrospective cohort study at Prof. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia. The data was collected from electronic medical records from January 2020 to December 2023. The inclusion criteria for this study were all adult patients (aged ≥ 18 years) with a first-time diagnosis of B-cell NHL. Exclusion criteria included patients with other types of cancer, not undergoing chemotherapy, and incomplete medical records. Survival analysis and factors associated with mortality were analyzed using Kaplan-Meier curves, log-rank test, and Cox proportional hazards regression.Results: There were 143 B-cell NHL patients who met the inclusion criteria. The 1-year overall survival rate in this study was 59.4%, with a median survival time of 9 months. The majority of the causes of patient mortality were disease progression (76.7%). An ECOG Performance Status ≥2 (HR = 3.362; 95% CI 1.949 – 5.799; p = 0.000) and high-grade histopathological features (HR = 3.002; 95% CI 1.193 – 7.556; p = 0.020) were significantly associated with poor survival in B-cell NHL patients.Conclusion: The 1-year survival rate of B-cell NHL patients in Bali remains relatively low compared to previous studies. An ECOG performance status ≥ 2 and high-grade histopathological features are prognostic factors for mortality in B-cell NHL patients in Bali.
Understanding Readmission Risks in End-Stage Kidney Disease: A Study from Wangaya Hospital Dewi, Ni Nyoman Gita Kharisma; Pratiwi, Made Sindy Astri; Agustini, Made Priska Arya; Dewi, Putu Itta Sandi Lesmana; Fahira, Cindy; Sunaka, I Wayan
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2025): Volume 2 No. 3, December 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i3.206

Abstract

Background: End-stage kidney disease (ESKD) is a growing health burden. Poor patient knowledge and treatment adherence contribute to increased morbidity, as reflected in readmission rates. Objective: This study aimed to identify factors associated with readmission among ESKD patients in Bali. Methods: A retrospective cohort study was conducted at Wangaya Hospital. Adult patients (≥18 years) diagnosed with ESKD, with or without dialysis, between 2022 and 2024 were included. Patients with incomplete records or a solitary kidney were excluded. Bivariate analysis (chi-square test) and multivariate analysis (binary logistic regression) were used to assess associations, with significance set at p <0.05. Results: A total of 199 patients met the inclusion criteria; 61.8% were male, with a median age of 57 years (range: 22–88 years). Readmission rates within and beyond one month were 18.6% and 15.1%, respectively. Reduced eGFR was significantly associated with 30-day readmission (p = 0.041). For readmission beyond 30 days, significant predictors included diabetes mellitus (p = 0.014), neurologic disorders (p < 0.001), and adherence (p = 0.019). Conclusion: eGFR predicts early readmission, while diabetes mellitus, neurological disorders, and treatment adherence influence later readmissions. Identifying these factors is vital for improving patient education and reducing healthcare burdens.
Co-Authors Dewi, Ni Nyoman Gita Kharisma Dewi, Putu Itta Sandi Lesmana Fahira, Cindy Pratiwi, Made Sindy Astri Rena, Made Renny Anggreni Rena, Ni Made Renny Anggreni Sunaka, I Wayan Yani, Made Violin Weda