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Childhood non-Hodgkin’s lymphoma in Cipto Mangunkusumo Hospital, Jakarta: Outcome of treatment 2000-2005 Djajadiman Gatot; Teny Tjitrasari; Novie Amelia Chozie
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.185-8

Abstract

Background Childhood non-Hodgkin’s lymphoma (NHL) is the thirdmost common solid tumor in Cipto Mangunkusumo, Jakarta. Since1992 there was no national report on the survival of children withNHL. To continue our observation on the result of treatment of chil-dren with NHL in our institution, we briefly report the outcome therapyof children with NHL who were admitted to our hospital during 2000-2005.Objective All patients who were diagnosed as non-Burkitt type NHLbetween January 2000-December 2005 were included in the study.Data collected retrospectively from the Oncology Registration ofHematology-Oncology Division, Department of Child Health, CiptoMangunkusumo Hospital, including age, sex, primary site of tumor,histopathology type, staging, treatment response, and outcome.Results A total of 24 patients were available. Male:female ratiowas 1.8:1. The age range was from 9 months to 11 years (median6 years). The histological type consisted of LL (3) and non-LL (11).Ten out of 14 patients were diagnosed as advanced stages (stagesIII and IV), while the rest were in stage II. Primary tumor site in LLtype were the head and neck (1), mediastinum (1), and testis (1),while the non-LL type patients had more varied site. Overall sur-vival of NHL was 78.6%+4.7%.Conclusion The overall survival of childhood NHL patients treatedwith protocol in our institution is in the range of survival that hadachieved in other centers worldwide, even with advanced stage ofdisease.
Left ventricular functions and mass of the adolescents and young adults with thalassemia major: An echocardiography study Muhammad Ali; Sukman Tulus Putra; Djajadiman Gatot; Sudigdo Sastroasmoro
Paediatrica Indonesiana Vol 46 No 5 (2006): September 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (358.123 KB) | DOI: 10.14238/pi46.5.2006.214-9

Abstract

Background Thalassemia major (TM) is a transfusion-depen-dent disease. Multiple transfusions cause an accumulation of ironin the body. On the heart, iron can induce cardiomyopathy, theleading cause of death in TM.Objective To evaluate left ventricular functions and mass amongadolescents and young adults with TM.Methods A cross-sectional study was conducted on 58 patientswith TM in Cipto Mangunkusumo Hospital, Jakarta. Hematologicaldata was collected from medical record. Left ventricular systolic func-tions (EF, FS), diastolic functions (A, E, E/A ratio, IVRT), and mass(LVDDi, LVDSi, LVMi) were detected using an echocardiographySonos 4500. T test, linier regression, and multiple regression analy-sis were performed.Results Out of 32 TM patients, 30 were enrolled to study. Leftventricular systolic and diastolic functions of TM patients were lowerthan those of the control and statistically significant [EF 66.1% (SD4.9) and 71.6% (SD 5.6); P<0.0001, FS 36.0% (SD 3.7) and 39.8%(SD 5.5); P=0.003, E/A 2.14 (SD 0.4) and 1.83 (SD 0.3); P=0.002,respectively]. Left ventricular mass of TM patients was greater thanthat of control, and also statistically significant [LVMi 111.1 g/m 2(SD 30.8) and 75.4 g/m 2 (SD 14.5); P<0.0001, respectively]. Linierand multiple regression analysis showed significant and powerfulcorrelation between left ventricular diastolic functions (E/A ratio)and serum ferritin concentration (r=0.71; P<0.0001).Conclusion Left ventricular functions and mass of adolescentsand young adults with TM show abnormalities. The higher the con-centration of ferritin serum is, the more likely for TM patient to suf-fer from diastolic abnormality
Relationships between plasma zinc and ferritin with nutritional status in thalassemic children Luszy Arijanty; Sri Sudaryati Nasar; Bambang Madiyono; Djajadiman Gatot
Paediatrica Indonesiana Vol 46 No 5 (2006): September 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (398.546 KB) | DOI: 10.14238/pi46.5.2006.220-4

Abstract

Background Repeated blood transfusions in thalassemic chil-dren can lead to iron overload in the body. High ferritin level leadsto low plasma zinc status because of their competitive inhibition.Previous study found that there was a correlation between plasmazinc level and nutritional status.Objective To obtain plasma zinc level, to investigate the correla-tion between plasma zinc and ferritin, and the impact of plasmazinc on nutritional status in children with thallasemia.Methods A cross sectional study was conducted on 67 thalas-semic children. This study was performed at Thalassemia Center,Cipto Mangunkusumo Hospital, Jakarta, from 1 st until 31 st of March2005. The age of the patients ranged from 4 to 18 years, with fer-ritin levels more than 2000 ng/ml during the last 6 months or totaltransfusion more than 5 liters. The subjects were divided into 2groups, i.e. group 1 (4-10 years) and group 2 (>10-18 years). Di-etary intake was assessed by 3 day-dietary recall. The nutritionalstatus were judged by mid upper arm circumference (MUAC) forage and height for age (H/A). Venous blood was obtained to mea-sure plasma zinc and ferritin levels. Statistical analysis was doneby Student’s t-test (2-tailed) and linear regression analysis.Results We found that 42% subjects were well-nourished, 51%were undernourished, and 7% were severely malnourished. All sub-jects had low plasma zinc status 31.9 (SD 16.9) μg/dl. There was aweak negative correlation between plasma zinc and ferritin level (r= -0.282, P=0.021). Lower zinc intake was detected in 65 out of 67subjects.Conclusion All thalassemic children in our hospital had low plasmazinc level. There was a weak negative correlation between plasmazinc level and ferritin level. There was no significant correlationbetween plasma zinc status and nutritional status
Rabdomiosarkoma Pada Anak: Gambaran Klinis di 2 Institusi Anky Tri Rini; Kusumaning Edhy; Djajadiman Gatot; Endang Windiastuti; Yanto Ciputra
Indonesian Journal of Cancer Vol 2, No 2 (2008): Apr - Jun 2008
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1676.103 KB) | DOI: 10.33371/ijoc.v2i2.40

Abstract

Rabdomiosarkoma (RMS) merupakan keganasan jaringan lunak yang banyak terjadi pada anak umur 1 sampai 5 tahun dan remaja. Sekitar 15 % anak dengan RMS datang dalam keadaan metastasis dan prognosisnya tidak ada perbaikan dalam 15 tahun terakhir.Penelitian ini untuk mengetahui keluaran terapi serta pengembangan selanjutnya Penelitian dilakukan secara retrospektif dari data pada catatan medis 30 pasien yang diterapi di RS Cipto Mangunkusumo (RSCM), Jakarta bulan Juni 2000 sampai Juli 2006 dan 11 pasien di RS Kanker Dharmais (RSKD), Jakarta bulan Januari 2003 sampai Desember 2007. Data dikumpulkan untuk melihat gambaran klinis dan keluaran terapi.Terdapat 30 pasien RMS di RSCM tahun 2000-2006 dan 11 di RSKD tahun 2003-2007. Perbandingan antara laki-laki dan perempuan adalah 2:1 (RSCM) dan 1:1,7 (RSKD).Kebanyakan menyerang anak umur antara 1 bulan sampai 5 tahun (43,3 % & 43,5 %) dengan median antara 6-7 tahun. Gambaran patologi terbanyak yaitu embrional (70% & 54,5%). Lokasi primer terbanyak pada bagian kepala dan leher (43,3% & 27,3%). Didapatkan stadium lanjut sebesar 80% & 45,5%. Sebagian besar metastasis ditemukan pada sumsum tulang (85,7% & 33,3%). Keluaran terapi didapatkan yang masih dalam terapi 66,7% & 27,3%, meninggal 30% & 18,2% dan lost to folloiv up 3,3% & 54,5%.RMS kebanyakan didapatkan pada anak umur 1 bulan sampai 5 tahun. Gambaran histologi tipe embrional dan lokasi primer pada kepala dan leher merupakan yang tersering. Pada umumnya, pasien datang dalam stadium lanjut tetapi jika datang pada stadium awal akan memberikan hasil yang lebih baik.Kata kunci: Rabdomiosarkoma, epidemiologi klinik, keluaran terapi.
Rabdomiosarkoma pada Anak: Luaran Klinis pada Pasien yang Mendapat Terapi Djajadiman Gatot; Endang Windiastuti
Indonesian Journal of Cancer Vol 5, No 2 (2011): Apr - Jun 2011
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (64.148 KB) | DOI: 10.14414/ijoc.v5i2.138

Abstract

Latar belakang. Rabdomiosarkoma (RMS) merupakan keganasan jaringan lunak yang banyak terjadi pada anak umur 1 sampai 5 tahun dan remaja. Sekitar 15 % anak dengan RMS datang dalam keadaan metastasis dan prognosisnya tidak ada perbaikan dalam 15 tahun terakhir.Tujuan. Penelitian ini untuk mengetahui gambaran epidemiologi RMS, hasil penanganannya dan luaran klinis untuk pengembangan selanjutnya.Metode. Penelitian dilakukan secara retrospektif dari data pada catatan medis 44 pasien yang diterapi di RS Cipto Mangunkusumo (RSCM), Jakarta bulan Juni 2000 sampai Juli 2008. Data dikumpulkan untuk melihat gambaran epidemiologi klinik dan luaran klinis.Hasil. Terdapat 44 pasien RMS di RSCM selama tahun 2000-2008.. Perbandingan antara laki-laki dan perempuan adalah 2:1 .Kebanyakan menyerang anak umur antara 3 bulan sampai 5 tahun (47,7% ) dengan median antara 6 -7 tahun. Gambaran patologi terbanyak yaitu embrional (65,9% ). Lokasi primer terbanyak pada bagian kepala dan leher (47,7% ). Berdasarkan sistem TNM , didapatkan stadium lanjut sebesar 61,4% . Sebagian besar metastasis ditemukan pada sumsum tulang (74%). Hasil luaran klinis didapatkan yang masih dalam terapi 52,3% , meninggal 36,4% dan lost to follow up 11,3% .Kesimpulan. RMS kebanyakan didapatkan pada anak umur 3 bulan sampai 5 tahun. Gambaran histologi tipe embrional dan lokasi primer pada kepala dan leher merupakan yang tersering. Pada umumnya, pasien datang dalam stadium lanjut tetapi jika datang pada stadium awal akan memberikan hasil yang lebih baik.Kata kunci Rabdomiosarkoma, epidemiologi klinik, luaran klinis
Red Blood Cell Transfusion for Pediatric Autoimmune Hemolytic Anemia in an Emergency Situation Murti Andriastuti; Ni Ken Ritchie; Kartika Anastasia Kosasih; Fakhri Muhammad; Anisa Dwi Fathinasari; Djajadiman Gatot
eJournal Kedokteran Indonesia Vol 9, No. 3 - Desember 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (127.865 KB) | DOI: 10.23886/ejki.9.19.230-5

Abstract

Autoimmune hemolytic anemia (AIHA) is often presented with severe anemia. Currently, several centers in Indonesia use washed red blood cells (RBCs) to transfuse AIHA patients. However, washed RBCs are not widely available, causing a delay in therapy. We herein report two cases of pediatric AIHA who presented with severe anemia with hemoglobin level of 4.1 g/dL and 5.3 g/dL. Both patients were delayed for two and five days to be given blood transfusion because of the unavailability of washed RBC in Sorong General Hospital and Fatmawati Hospital and must wait to be referred to RSCM to receive washed RBCs. We conducted literature searches to review several articles that focus on AIHA transfusion management. AIHA is characterized by the production of autoantibodies directed against antigens on the surface of RBCs. RBC washing is not currently required in AIHA patients. It is also not widely available, takes a long time to process, and can cause a delay in emergency cases. Although RBC transfusion is not contraindicated in AIHA, its use should be limited to life-threatening cases of anemia with signs of cardiac and neurological compromises. In emergency cases, ABOmatched and Rhesus-matched RBCs can be safely administered if alloantibodies are reasonably excluded based on the previous transfusion and pregnancy history. ABO-matched and Rh-matched RBC transfusion is safe as AIHA’s transfusion management for patients with severe anemia with clinical symptoms.