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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Mutiara Medika: Jurnal Kedokteran dan Kesehatan Biomedika The Indonesian Biomedical Journal Medical Laboratory Technology Journal Jurnal Gizi Klinik Indonesia Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Journal of Community Empowerment for Health Journal of Informatics, Information System, Software Engineering and Applications (INISTA) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
Tri Ratnaningsih
Clinical Pathology Departement, Medicine Public Health And Nursing Faculty, Universitas Gadjah Mada
Biochemistry, Genetics & Molecular Biology Computer Science & IT Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)

 1 
THE DIFFERENCE LEVEL OF MYELOPEROXIDASE IN PLATELET CONCENTRATE BASED ON PREPARATION METHOD AND STORAGE DURATION Fuad Anshori; Teguh Triyono; Tri Ratnaningsih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1462

Abstract

The thrombocyte concentrate (TC) preparation process through its storage affects the platelets contained inside. The contaminating leukocytes in TC is an important factor implicated in storage lesion on TC during storage. Leukodepletion is a method to reduce contaminant leukocytes. Myeloperoxidase (MPO) is an enzyme produced by polymorphonuclear cells that have the potential to change structure and function of platelets when there is interaction between them during storage. The aim of this study is assessing the difference in myeloperoxidase level of TC based on its preparation method (leukodepleted and non-leukodepleted) and time storage. A cross-sectional observational study was conducted at the Blood Transfusion Services Unit, Dr. Sardjito hospital, Yogyakarta from April to December 2014. Thrombocyte Concentrate products was grouped based on storage time (≤ and >72 hours) and preparation method (leukodepleted and non-leukodepleted), their MPO was then measured. Mean difference in each group was analyzed using ANOVA test and post hoc test with statistical significance level of p < 0.05. There were 64 eligible subjects, consisted of 29 leukodepleted TCs and 35 non-leukodepleted TCs, based on their storage time, 31 TCs had ≤72 hours storage  time and the other 33 TCs > 72 hours. There were significantly lower median MPO level in ≤72 hours TCs than > 72 hours in non-leukodepleted TC group (13.23 ± 6.47 ng/mL vs 15.58 ± 7.82 ng/mL; p = 0.017). In TC group with more than 72 hours storage time, median MPO level in non-leukodepleted was significantly higher than leukodepleted TC (15.58 ± 7.82 ng/mL vs. 11.11 ± 3.97 ng/mL; p = 0,001). Myeloperoxidase level was lower in non-leukodepleted TC group with ≤ 72 hours than > 72 hours storage time. Furthermore, the MPO level was higher in leukodepleted TC than non-leukodepleted TC in > 72 hours storage time.
Hematology and Iron Status Evaluation Based on Donation Characteristics in Dr. Sardjito Hospital, Yogyakarta Fuad Anshori; Tri Ratnaningsih; Teguh Triyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1876

Abstract

Blood donation will reduce iron storage in the body. A high frequency of donations and short interval inter-donations may increase the risk of iron deficiency. In Indonesia, detection of iron deficiency in blood donors is not a routine procedure. Therefore, the comparison of hematology and iron status based on donor characteristics is not widely known. For a month, this study was a cross-sectional study conducted at the Blood Transfusion Service Unit, Dr. Sardjito Hospital. Subjects were routine blood donors who met the criteria for donor selection; however, subjects were excluded if the CRP level was > 10 g/L and had a history of iron supplementation. Subjects were divided based on donation frequency and blood donation interval. The Kruskal-Wallis test was used to compare variables among groups with a statistical significance of p < 0.05. This study involved 145 subjects who met the criteria. Blood donations more than 20 times showed the lowest ferritin levels and iron saturation (16.9 ng/mL and 15.08%). Ferritin levels were also increased in line with the donation interval (35.5 ng/mL; 75.3 ng/mL; 92.7 ng/mL every three months). However, the hematological parameters and iron saturation did not differ significantly based on the donation interval. Hematological parameters are easy and fast procedures but have limitations in the early detection of iron deficiency. Serum ferritin has higher specificity, but its level is affected by inflammatory conditions. Ferritin levels were consistently at the lowest level in the subjects with the highest risk of iron deficiency compared to hematologic and iron saturation parameters.
Abnormal Complex Karyotyping in A Patient Suspected of Acute Myeloblastic Leukemia (AML-M5): A Case Study Purbosari Purbosari; Usi Sukorini; Rahmat Dani Satria; Tri Ratnaningsih; Setyawati Setyawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1762

Abstract

Hemophagocytic Lymphohistiocytosis (HLH) is a condition of immune dysregulation characterized by severe organ damage induced by a hyperinflammatory response and uncontrolled T-cell and macrophage activation. Patients with Acute Myeloblastic Leukemia (AML) may be prone to develop HLH. Hemophagocytic lymphohistiocytosis syndrome in AMLpatients with an abnormal complex karyotyping can worsen the patients' prognosis and outcome. A 47-year-old-female presented with prolonged fever, chills, fatigue, weight loss, productive cough, and anemia (blood transfusion (+)). Laboratory findings: hemoglobin 8.5 g/dL, WBC 151.99x103/μL, and platelet count 28x103/μL, peripheral blood 13% blast like cells, 19% promonocytes, 43% atypical (bizarre) monocytes, 25% neutrophils. Levels of CRP>150 mg/L and procalcitonin 82.67 ng/mL, negative HBsAg, and positive IGRA test. Bone marrow morphology showed hypercellularity, decreased thrombopoiesis and erythropoiesis, increased granulopoiesis, macrophages, and hemophagocytosis. Karyotyping results: abnormal karyotypes: 46: XX (9 cells), 44: X (-18), 45: XX (-4), 45: XX (+7, -2, -16), 46: XX (chtb (3), chtb (4), chtb (5), chtb (9), chtb (12), chtb (22)), 46: XX (chtb (5), chtb (7)), 46: XX (chtb (6), chtb (12)), 46: XX (dic 2), 46: XX (chtb (1) (q12), chtb (3) (p21)), 46: XX (chtb (X) (q25) ), 46: XX (der (9), dic (9)), t (9:22)), 46: XX ((+ 21), (-13) chtb (2), p (23), t ( 9:22)). The conclusion was abnormal complex karyotyping. High concentrations of inflammatory cytokines (interleukin-1, interleukin-6, TNF-alpha, and interferon-gamma) secreted by malignant cells and increased phagocytic function of leukemic cells play an important role in the pathogenesis of HLH. Monocytic components (subtypes AML4 and AML5 of the FAB classification) are predisposing factors in cases of AML-related HLH. Cytogenetic abnormalities involving 8p11 and 16p13 are more common in AML-related HLH. Complex genetic abnormalities exacerbate the prognosis of AML, especially in treatment failure. A concluded that was diagnosed with HLH due to AML-M5 with genetic abnormalities of BCR ABL (+), monosomy, trisomy, and multiple chromatid breakage with high mortality. Karyotyping examination is important to determine the prognosis of the disease.
THE DIFFERENCE LEVEL OF MYELOPEROXIDASE IN PLATELET CONCENTRATE BASED ON PREPARATION METHOD AND STORAGE DURATION Fuad Anshori; Teguh Triyono; Tri Ratnaningsih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1462

Abstract

The thrombocyte concentrate (TC) preparation process through its storage affects the platelets contained inside. The contaminating leukocytes in TC is an important factor implicated in storage lesion on TC during storage. Leukodepletion is a method to reduce contaminant leukocytes. Myeloperoxidase (MPO) is an enzyme produced by polymorphonuclear cells that have the potential to change structure and function of platelets when there is interaction between them during storage. The aim of this study is assessing the difference in myeloperoxidase level of TC based on its preparation method (leukodepleted and non-leukodepleted) and time storage. A cross-sectional observational study was conducted at the Blood Transfusion Services Unit, Dr. Sardjito hospital, Yogyakarta from April to December 2014. Thrombocyte Concentrate products was grouped based on storage time (≤ and >72 hours) and preparation method (leukodepleted and non-leukodepleted), their MPO was then measured. Mean difference in each group was analyzed using ANOVA test and post hoc test with statistical significance level of p < 0.05. There were 64 eligible subjects, consisted of 29 leukodepleted TCs and 35 non-leukodepleted TCs, based on their storage time, 31 TCs had ≤72 hours storage  time and the other 33 TCs > 72 hours. There were significantly lower median MPO level in ≤72 hours TCs than > 72 hours in non-leukodepleted TC group (13.23 ± 6.47 ng/mL vs 15.58 ± 7.82 ng/mL; p = 0.017). In TC group with more than 72 hours storage time, median MPO level in non-leukodepleted was significantly higher than leukodepleted TC (15.58 ± 7.82 ng/mL vs. 11.11 ± 3.97 ng/mL; p = 0,001). Myeloperoxidase level was lower in non-leukodepleted TC group with ≤ 72 hours than > 72 hours storage time. Furthermore, the MPO level was higher in leukodepleted TC than non-leukodepleted TC in > 72 hours storage time.
Abnormal Complex Karyotyping in A Patient Suspected of Acute Myeloblastic Leukemia (AML-M5): A Case Study Purbosari Purbosari; Usi Sukorini; Rahmat Dani Satria; Tri Ratnaningsih; Setyawati Setyawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1762

Abstract

Hemophagocytic Lymphohistiocytosis (HLH) is a condition of immune dysregulation characterized by severe organ damage induced by a hyperinflammatory response and uncontrolled T-cell and macrophage activation. Patients with Acute Myeloblastic Leukemia (AML) may be prone to develop HLH. Hemophagocytic lymphohistiocytosis syndrome in AMLpatients with an abnormal complex karyotyping can worsen the patients' prognosis and outcome. A 47-year-old-female presented with prolonged fever, chills, fatigue, weight loss, productive cough, and anemia (blood transfusion (+)). Laboratory findings: hemoglobin 8.5 g/dL, WBC 151.99x103/μL, and platelet count 28x103/μL, peripheral blood 13% blast like cells, 19% promonocytes, 43% atypical (bizarre) monocytes, 25% neutrophils. Levels of CRP>150 mg/L and procalcitonin 82.67 ng/mL, negative HBsAg, and positive IGRA test. Bone marrow morphology showed hypercellularity, decreased thrombopoiesis and erythropoiesis, increased granulopoiesis, macrophages, and hemophagocytosis. Karyotyping results: abnormal karyotypes: 46: XX (9 cells), 44: X (-18), 45: XX (-4), 45: XX (+7, -2, -16), 46: XX (chtb (3), chtb (4), chtb (5), chtb (9), chtb (12), chtb (22)), 46: XX (chtb (5), chtb (7)), 46: XX (chtb (6), chtb (12)), 46: XX (dic 2), 46: XX (chtb (1) (q12), chtb (3) (p21)), 46: XX (chtb (X) (q25) ), 46: XX (der (9), dic (9)), t (9:22)), 46: XX ((+ 21), (-13) chtb (2), p (23), t ( 9:22)). The conclusion was abnormal complex karyotyping. High concentrations of inflammatory cytokines (interleukin-1, interleukin-6, TNF-alpha, and interferon-gamma) secreted by malignant cells and increased phagocytic function of leukemic cells play an important role in the pathogenesis of HLH. Monocytic components (subtypes AML4 and AML5 of the FAB classification) are predisposing factors in cases of AML-related HLH. Cytogenetic abnormalities involving 8p11 and 16p13 are more common in AML-related HLH. Complex genetic abnormalities exacerbate the prognosis of AML, especially in treatment failure. A concluded that was diagnosed with HLH due to AML-M5 with genetic abnormalities of BCR ABL (+), monosomy, trisomy, and multiple chromatid breakage with high mortality. Karyotyping examination is important to determine the prognosis of the disease.
Hematology and Iron Status Evaluation Based on Donation Characteristics in Dr. Sardjito Hospital, Yogyakarta Fuad Anshori; Tri Ratnaningsih; Teguh Triyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1876

Abstract

Blood donation will reduce iron storage in the body. A high frequency of donations and short interval inter-donations may increase the risk of iron deficiency. In Indonesia, detection of iron deficiency in blood donors is not a routine procedure. Therefore, the comparison of hematology and iron status based on donor characteristics is not widely known. For a month, this study was a cross-sectional study conducted at the Blood Transfusion Service Unit, Dr. Sardjito Hospital. Subjects were routine blood donors who met the criteria for donor selection; however, subjects were excluded if the CRP level was > 10 g/L and had a history of iron supplementation. Subjects were divided based on donation frequency and blood donation interval. The Kruskal-Wallis test was used to compare variables among groups with a statistical significance of p < 0.05. This study involved 145 subjects who met the criteria. Blood donations more than 20 times showed the lowest ferritin levels and iron saturation (16.9 ng/mL and 15.08%). Ferritin levels were also increased in line with the donation interval (35.5 ng/mL; 75.3 ng/mL; 92.7 ng/mL every three months). However, the hematological parameters and iron saturation did not differ significantly based on the donation interval. Hematological parameters are easy and fast procedures but have limitations in the early detection of iron deficiency. Serum ferritin has higher specificity, but its level is affected by inflammatory conditions. Ferritin levels were consistently at the lowest level in the subjects with the highest risk of iron deficiency compared to hematologic and iron saturation parameters.
Co-Authors . Suhartini Abdul Wahab Adika Zhulhi Arjana Ainun Nisa Aji Bagus Widyantara Arta Farmawati Arum Tri Wahyuningsih Bambang Sasangka Budi Mulyono Budiatri Retno Noormaningrum Busyra Busyra Dea Noviana Pramantik Desin Pambudi Sejahtera Dyah Aruming Tyas Elizabeth Henny Herningtyas Emy Huriyati Fuad Anshori Indarwati Setyaningsih Ismail Setyopranoto Maria Agnes Etty Dedy Maria Agnes Etty Dedy marsa, mardhatillah Nasution, Annio Indah Lestari Nur Imma Fatimah Harahap Purbosari Purbosari Rahmat Dani Satria Setyawati Setyawati Sri Sutarni Suhartini Suhartini Suhartini Suhartini Teguh Triyono Teguh Triyono Usi Sukorini Wirimena Hurimah Yudha Nurhantari