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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Paediatrica Indonesiana
Harijadi Harijadi
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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High number of granzyme B expressing CTLs predicts worst prognosis of nasopharygeal carcinoma patients Harijadi Harijadi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 01 (2008)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Background: Nasopharyngeal carcinoma (NPC) characteristically harbors many tumor-infiltrating lymphocytes. In biopsies of Hodgkin or anaplastic large cell lymphoma many activated CTLs are related to a very poor clinical outcome, suggesting that in these cases with a strong CTL mediated anti-tumor cell response, selection occurs for tumor cells that have become resistant to CTL and chemo and/or radiotherapy induced apoptosis. Only activated CTLs and natural killer cells express granzyme B.Objective. Since, similar to lymphomas, the prognosis of NPC patients depends primarily on the sensitivity of tumor cells to radio- and/or chemotherapy, this study investigated whether the presence of many tumor-infiltrating activated CTLs in tumor biopsies also predicts poor prognosis in NPC patients.Methods: The study investigated 39 specimens of Indonesian NPC patients that fulfilled the following criteria; no evidence of distant metastases at the time of diagnosis, and complete remission following complete radio- and/or chemotherapy. Number of tumor-infiltrating activated CTLs was detected using a combination of antibodies against granzyme Band CD3, CD8 and CD56.Results: The presence of a high number of tumor infiltrating activated CTLs expressing granzyme B appeared to be a very strong predictor of a rapid fatal clinical outcome. Its prognostic value was stronger than and independent from the other prognostic makers; age and clinical TNM stage at presentation. Prognosis was found to decline strongly with increasing percentage of activated CTLs. The most informative cut-off value was found to be 25%. The median overall survival time of patients with
The prevalence of factor VIII inhibitor in patients with severe hemophilia-A and its clinical characteristics Harijadi Harijadi; Djajadiman Gatot; Arwin AP Akib
Paediatrica Indonesiana Vol 45 No 4 (2005): July 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.4.2005.177-81

Abstract

Background Hemophilia is a hereditary blood-clotting disorderdue to factor VIII deficiency. Up to this date, the administration offactor VIII in preventing and managing bleeding has been the maintreatment. One of the complications, which may occur due to re-peated administrations of factor VIII, is the formation of factor VIIIantibody (factor VIII inhibitor).Objective To find out the prevalence of severe hemophilia-A withfactor VIII inhibitor and its clinical characteristics.Methods A cross-sectional descriptive study was performed onchildren with severe hemophilia-A at the National Hemophilia CareCentre, Cipto Mangunkusumo Hospital, Jakarta, Indonesia, in June-August 2004.Results Out of 45 children studied, 16 had factor VIII inhibitor withaverage inhibitor titre of 1.15 Bethesda units (BU) (range 0.15-15BU). Most of them (12 patients) had inhibitor titre <5 BU. Chronicarthropathy was found in 17 out of 45 (37%) children with severehemophilia-A, consisting of nine patients from positive inhibitorgroup and 8 patients from negative inhibitor group. Thirty-ninepatients (86%) used an on-demand treatment pattern, among whom15 had positive inhibitor. Among patients receiving prophylactictreatment pattern, only one had positive inhibitor. There were 39patients (86%) treated using cryoprecipitate, among whom factorVIII inhibitor was found in 12, while among those treated with fac-tor VIII concentrate, the inhibitor was positive in 4/6. The averageamount of factor VIII transfused in positive and negative factor VIIIinhibitor groups was similar.Conclusion The prevalence of factor VIII inhibitor in severe he-mophilia-A patients was 35%. Chronic arthropathy occurred moreoften in patients with positive factor VIII inhibitor. Factor VIII inhibi-tor was found more frequently in patients with an on-demand treat-ment pattern and in those using factor VIII concentrate
Co-Authors Arwin AP Akib Djajadiman Gatot