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All Journal Indonesian Journal of Urology Folia Medica Indonesiana Indonesian Journal of Tropical and Infectious Disease Sari Pediatri Paediatrica Indonesiana Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) MEDICINUS
Bambang Permono
And Department Of Child Health, Universitas Airlangga Medical School/Dr. Soetomo General Hospital, Surabaya, East Java
Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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Hyperglycemia in Childhood Acute Lymphoblastic Leukemia during Induction Chemotherapy Nengcy Erlina Tasik Rerung; Cahyadi, Andi; Nur Rochmah; Maria Christina Shanty Larasati; Andarsini, Mia Ratwita; Muhammad Faizi; IDG Ugrasena; Bambang Permono
MEDICINUS Vol. 34 No. 1 (2021): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (76.129 KB) | DOI: 10.56951/medicinus.v34i1.49

Abstract

Introduction: Hyperglycemia is a well-known adverse effect of the corticosteroids and asparaginase given during induction chemotherapy for pediatric acute lymphoblastic leukemia (ALL). ALL is a type of hematologic malignancy with high incidence in the childhood. The aim of this study is to investigate the impact of hyperglycemia during induction chemotherapy in childhood ALL. Methods: This prospective study was done in Dr. Soetomo hospital from January to April 2018. The subject was newly diagnosed as ALL under the age of 18 years, treated with Indonesian childhood ALL 2013 protocol (standard risk (SR) group and high risk (HR) group). Hyperglycemia was defined as at least two separate random plasma glucose levels >200 mg/dL, which was evaluated before and during induction chemotherapy. Statistical analysis using Paired T-test for parametric and Wilcoxon test for nonparametric. Results: Thirty-three children were enrolled, 18/33 boys with mean age 5.8 (SD 3.78) years, compromised as ALL-L1 30/33. They were treated with ALL-HR 19/33 and ALL-SR 14/33. In overall groups, the mean random blood glucose level significantly increased from 108 (SD 21.3) mg/dl to 147 (SD 48.1) mg/dl, (mean difference 38.67 mg/dl; 95% CI 18.08 to 59.26 mg/dl, p=0.008). In SR group, there was a significant increase of mean random blood glucose level from 102 (SD 13.5) mg/dl to 133 (SD 37.3) mg/dl, (mean difference 31.8 mg/dl; 95% CI 8.78 to 54.8 mg/dl; p=0.01). In HR group, the mean random blood glucose level increased from 113 (SD 51.9) mg/dl to 165 (SD 25.4) mg/dl, (mean difference 51.9 mg/dl; 95% CI 18.6 to 85.2 mg/dl, p=0.004). Conclusion: Blood glucose level is significantly increase during induction chemotherapy in both SR and HR Indonesian childhood ALL 2013 protocol.
METHOTREXATE USE IS SAFE IN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA Utomo, Febriansyah Nur; Yulistiani, Yulistiani; Zairina, Nun; Permono, Bambang
Folia Medica Indonesiana Vol. 53 No. 2 (2017): JUNE 2017
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (261.006 KB) | DOI: 10.20473/fmi.v53i2.6431

Abstract

Monitoring level of methotrexate is not only aimed at monitoring effectiveness, but also safety aspects of the administration of high-dose methotrexate because the use of high-dose methotrexate is one of the problems associated with toxicity in various organs.  In the use of high-dose methotrexate, measurement of methotrexate is important to identify patients with a high risk of toxicity, particularly nephrotoxicity as well as for dosing guidelines for leucovorin therapy. The aim of this study was to analyze the safety of high-dose methotrexate on kidney function during chemotherapy consolidation phase in children with acute lymphoblastic leukemia. This was a longitudinal, observational prospective study conducted to determine the safety profile of high-dose methotrexate on kidney function during chemotherapy consolidation phase in children with acute lymphoblastic leukemia. Patients who met the inclusion criteria were given high-dose methotrexate according to the 2013 Indonesian ALL Chemotherapy Protocol. Measurement of methotrexate level and kidney function was done 3 times on each cycle of chemotherapy consolidation phase. Measurements were made on the 0, 24 and 48 hours after the first drop of high-dose methotrexate. This study had been reviewed by Ethics Committee of Dr. Soetomo Hospital Surabaya. There were 12 patients who met inclusion criteria and 6 patients among them had finished their chemotherapy consolidation phase completely. There was no significant change in kidney function after the administration of high-dose methotrexate compared to baseline (p>0.05) and there was no significant correlation between serum level of methotrexate versus creatinine clearance. In conclusion, methotrexate was safe to use in children with acute lymphoblastic leukemia.
Co-Authors Ahmad Suryawan Andi Cahyadi Annie Kusumadewi F. X. Santoso Fatimah lndarso I Dewa Gede Ugrasena IDG Ugrasena Komang Ayu Witarini Landia Setiawati Mangihut Rumiris Maria Christina Shanty Larasati Mia Ratwita Mia Ratwita Andarsini Moersintowarti B. Narendra Moersintowati B. Narendra Muhammad Faizi Nengcy Erlina Tasik Rerung Netty R. H. T. Nun Zairina, Nun Nur Rochmah Renny Suwarniaty Retno Asih Risa Etika, Risa Risky Vitria Prasetyo S. Untario Shanty, Maria Christina Sherly Yuniarchan, Sherly Sudigdo Sastroasmoro Sukardi Sukardi Teddy Ontoseno Utomo, Febriansyah Nur Widiaskara IM Yulistiani Yulistiani, Yulistiani