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All Journal Jurnal Kedokteran Syiah Kuala Acta Interna : The Journal of Internal Medicine Journal of the Medical Sciences (Berkala Ilmu Kedokteran) The Indonesian Biomedical Journal Smart Medical Journal
Ibnu Purwanto
Department Of Internal Medicine, Faculty Of Medicine, Universitas Gadjah Mada/ Dr. Sardjito Hospital, Yogyakarta
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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THE COGNITIVE FUNCTION OF ANTHRACYCLINE-BASED ADJUVANT CHEMOTHERAPY IN WOMEN WITH BREAST CARCINOMA Sendjaja, Sukendro; Purwanto, Ibnu; Kurnianda, Johan
Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

ABSTRACT Objective. The objective of this study was to determine the changes cognitive function of anthracycline-based adjuvant chemotherapy in women with breast carcinoma.Method. The study design was prospective longitudinal study. The breast cancer patients who received anthracycline-based adjuvant chemotherapy were recruited from internal medicine wards and TULIP outpatient department Dr. Sardjito General Hospital Yogyakarta. Subjects eligible with inclusion and exclusion criteria were examined for cognitive function by mini-mental state examination (MMSE) before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3). The mean difference of MMSE scores were analyzed with Wilcoxon-signed rank test and P<0.05 was considered statistically significant.Result. There were 47 subjects eligible to study criteria in October 1st 2008 – October 31st 2009. Forty subjects finished this study and were analyzed. The mean age was 47.08±6.65 with age ranged from 27 to 61 years old. The mean MMSE scores before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3) were 29.28±1.20, 28.60±1.69, 28.18±1.89, and 27.85±2.03, respectively. The mean MMSE score changes (ΔT0-T1), (ΔT0-T2), and (ΔT0-T3) were 0.68±0.80, 1.10±1.06, and 1.43±1.36, respectively and P<0,001. The incidence of cognitive impairment with MMSE scores < 24 was 2.5% and P=1.0.Conclusion. There was a significant decline of MMSE score in women with breast carcinoma who received anthracycline-based adjuvant chemotherapy at 3 weeks after 2nd adjuvant chemotherapy, 3 weeks after 4th adjuvant chemotherapy, and 3 months after 4th adjuvant chemotherapy compared with before chemotherapy. Key Words: Cognitive Function, Breast Cancer, Adjuvant Chemotherapy, Anthracycline 
Trombosis pada corona virus disease (COVID-19) Agus Jati Sunggoro; Ibnu Purwanto; Maryatun Hasan
Jurnal Kedokteran Syiah Kuala Vol 20, No 3 (2020): Volume 20 Nomor 3 Desember 2020
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jks.v20i3.18689

Abstract

Abstrak. Coronavirus Disease 2019 (COVID-19) telah menyebabkan masalah kesehatan di seluruh dunia dengan morbiditas dan mortalitas yang terus meningkat. Pada beberapa kasus COVID-19 diketahui terjadi manifestasi trombotik. Adanya kelainan trombotik ini tentunya mempengaruhi tatalaksana dan prognosis pasien COVID-19. Oleh karena itu penting untuk mengetahui patofisiologi dan manajemen trombosis pada COVID-19. Tujuan dari artikel ini adalah mengulas literatur terbaru terkait prevalensi, patofisiologi, penilaian risiko, serta manajemen trombosis pada COVID-19.Kata kunci: COVID-19, trombosis.Abstract. Coronavirus Disease 2019 (COVID-19) has become a global health problem with ever increasing morbidity and mortality. In some cases, thrombotic manifestation has been reported in COVID-19 patients. This thrombotic manifestation certainly affects the management and prognosis of COVID-19 patients. Therefore it is crucial to understand the pathophysiology and management of thrombosis in COVID-19. The aim of this article is to review the recent literature regarding prevalence, pathophysiology, risk assessment, and management of thrombosis in COVID-19.Keywords:COVID-19, thrombosis
THE COGNITIVE FUNCTION OF ANTHRACYCLINE-BASED ADJUVANT CHEMOTHERAPY IN WOMEN WITH BREAST CARCINOMA Sukendro Sendjaja; Ibnu Purwanto; Johan Kurnianda
Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1458.487 KB) | DOI: 10.22146/acta interna.3868

Abstract

ABSTRACT Objective. The objective of this study was to determine the changes cognitive function of anthracycline-based adjuvant chemotherapy in women with breast carcinoma.Method. The study design was prospective longitudinal study. The breast cancer patients who received anthracycline-based adjuvant chemotherapy were recruited from internal medicine wards and TULIP outpatient department Dr. Sardjito General Hospital Yogyakarta. Subjects eligible with inclusion and exclusion criteria were examined for cognitive function by mini-mental state examination (MMSE) before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3). The mean difference of MMSE scores were analyzed with Wilcoxon-signed rank test and P<0.05 was considered statistically significant.Result. There were 47 subjects eligible to study criteria in October 1st 2008 – October 31st 2009. Forty subjects finished this study and were analyzed. The mean age was 47.08±6.65 with age ranged from 27 to 61 years old. The mean MMSE scores before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3) were 29.28±1.20, 28.60±1.69, 28.18±1.89, and 27.85±2.03, respectively. The mean MMSE score changes (ΔT0-T1), (ΔT0-T2), and (ΔT0-T3) were 0.68±0.80, 1.10±1.06, and 1.43±1.36, respectively and P<0,001. The incidence of cognitive impairment with MMSE scores < 24 was 2.5% and P=1.0.Conclusion. There was a significant decline of MMSE score in women with breast carcinoma who received anthracycline-based adjuvant chemotherapy at 3 weeks after 2nd adjuvant chemotherapy, 3 weeks after 4th adjuvant chemotherapy, and 3 months after 4th adjuvant chemotherapy compared with before chemotherapy. Key Words: Cognitive Function, Breast Cancer, Adjuvant Chemotherapy, Anthracycline 
Telomere and telomerase in hematological disorders Focusing on bone marrow failure syndromes and hematological malignancies Mardiah Suci Hardianti; Ibnu Purwanto; Johan Kurnianda
Acta Interna The Journal of Internal Medicine Vol 4, No 2 (2014): The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (404.728 KB) | DOI: 10.22146/acta interna.16928

Abstract

ABSTRACTWe review the present knowledge of telomeres and telomerase with special attention to their role in hematological disorders especially bone marrow failure syndromes including acquired aplastic anemia and myelodysplastic syndromes, as well as acute and chronic myeloid leukemia. The current understanding on the role of telomere and telomeres dysfunctions in hematological disorders leads us to a better understanding on the pathology of the diseases as well as considering some possibilities to employ the measurement of telomere length and telomere activity in disease prognostication. Several treatment options targeting telomere and telomerase being developed are also reviewed.Keywords: telomere- telomerase- bone marrow failure syndromes- hematological malignancies
Incorporation of Brentuximab Vedotin in the Treatment of Lymphoma: Current Evidence and Potential Use in Indonesia Ibnu Purwanto
Acta Interna The Journal of Internal Medicine Vol 10, No 1 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.61344

Abstract

Although scientific advances have resulted in significantly improved survival among lymphoma patients, certain subsets of lymphoma patients still have poor prognosis, which includes relapsed and treatment refractory patients. Brentuximab vedotin, an anti-CD30 targeted therapy has shown remarkable results given in both Hodgkin and non-Hodgkin lymphoma, even in cases without CD30 expression. Unfortunately, evidence of its effectiveness in Indonesian patient is still limited as there is only 1 case report of such subject published.Conclusion: Brentuximab vedotin, an anti-CD30 targeted therapy presents as an effective therapeutic option for relapsed and treatment refractory lymphoma patients.
Impressive Result of Gemcitabine and Cisplatin Combination Therapy in Post-Operative Residual Cholangiocarcinoma Patient Presenting with Hyperbilirubinemia, an Experience in Indonesian Tertiary Hospital Ibnu Purwanto; Agus Barmawi; Bambang Purwanto Utomo; Ahmad Ghozali
Acta Interna The Journal of Internal Medicine Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.62846

Abstract

Introduction: Cholangiocarcinoma (CCA) often presents at an inoperable or an advanced stage in which complete resection is not possible. In such scenario, chemotherapy often is the only option to improve patient’s survival. Severe hyperbilirubinemia, often associated with higher risk of developing chemotherapy-related adverse event, might complicates one’s decision in choosing chemotherapy regimen. Case Report: We present a case of 63-year-old post-operative CCA patient with residual mass and severe hyperbilirubinemia. The patient completed six cycles of gemcitabine (1000 mg/m2, day 1 and 8) and cisplatin (70 mg/m2, day 1) every 3 weeks with tolerable side effect. No sign of residual tumor was observed on CT-Scan performed one-month post chemotherapy. Conclusion: Combination of cisplatin and gemcitabine may offer safe treatment option for post-operative residual CCA patient presenting with hyperbilirubinemia.
Diffuse Large B-Cell Lymphoma Complicated by Small Bowel Obstruction after Radiotherapy: a Case Study Diah Ari Safitri; Kartika Widayati Taroeno-Hariadi; Johan Kurnianda; Ibnu Purwanto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 3 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (15.012 KB) | DOI: 10.19106/JMedSci004803201606

Abstract

ABSTRACTAlthough the spleen is frequently involved in disseminated non-Hodgkin’s lymphoma (NHL), splenic presentation as the initial or only site of disease is uncommon. Treatment modalities include surgery, chemotherapy, and radiation therapy. The priority of cancer follow up is to perform surveillance for recurrent cancer and evaluation of treatment response. Side effects of treatment are frequently missed or overlooked. A 66-year-old woman was presented to our hospital with a month history of spleen enlargement. On physical examination the spleen was palpated at Schuffner 2. Abdominal MSCT scan was suggestive of lymphoma. Surgery revealed adhesion and obstruction of the stomach. Biopsy and gastrojejunostomy shunting were done, but splenectomy was difficult. The pathology anatomy findings confirmed the diagnosis of diffuse non Hodgkin’s lymphoma large B-cell type. Immunohistochemistry showed positive CD3 and CD20. She underwent 6 cycles of rituximab, cyclophosphamide, adriamycin, vincristine, and prednisolone (RCHOP) chemotherapy. CT evaluation done 7 months later revealed that the hilus lienalis lymph nodes and spleen has decrease in size. However, a lumbosacral x-ray done due to back pain revealed metastasis on her 1st and 2nd lumbal spine. After a single fraction of radiotherapy, nausea, vomiting and abdominal distension occurred. A 3 position abdominal x-ray revealed signs of small bowel obstruction. After surgery she has received 9 cycles of zoledronic acid and remained in good condition and ambulatory. Splenic presentation as the initial or only site of non-Hodgkin’s lymphoma (NHL) is uncommon. Acute small bowel obstruction and fistula due to palliative radiation therapy for bone metastasis needs prompt and appropriate treatment.
Treatment options for Indonesian triple negative breast cancer patients: a literature review of current state and potentials for future improvement Ibnu Purwanto; Iwan Dwiprahasto; Teguh Aryandono; Sofia Mubarika
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 1 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (318.402 KB) | DOI: 10.19106/JMedSci005201202009

Abstract

 Triple negative breast cancer (TNBC) is still associated with grave prognosis, especially compared to other breast cancer subtypes. Advances in medical science have improved our understanding on the biological nature and heterogeneity of TNBC, explaining the efficacy variability of existing chemotherapeutic drugs on TNBC patients. Complexity of TNBC has led to wide variation of TNBC treatment across the globe, resulting in unsatisfactory treatment outcome. This issue is further complicated by the absence of TNBC treatment guideline in many countries, including in Indonesia. This review discusses systemic treatment options for TNBC while taking account its molecular heterogeneity. Specific consideration is made for Indonesia, not only for current clinical practice, but also for future improvements. Immunotherapy, especially programmed cell death 1 (PD-1/PD-L1) inhibitor, has recently shown promising result in TNBC patients. It can be concluded that TNBC is heterogenous and treatment option should be tailored based on its molecular profile.
Excellent response of rituximab and bendamustine in elderly patient with relapsed diffuse large B-cell lymphoma: a case report Wiwiek Probowati; Merari Panti Astuti; Bambang Purwanto Utomo; Mardiah Suci Hardiyanti; Ibnu Purwanto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 1 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (387.85 KB) | DOI: 10.19106/JMedSci005301202110

Abstract

Rituximab in combination with cyclophosphamide, doxorubicin, vincristine,and prednisone (R-CHOP) is currently the most widely used first-line therapyfor aggressive B-cell lymphomas. However, many patients, including thosewith organ dysfunction, may not tolerate the toxicities associated with thisregimen. Recent data from the phase III study group indolent lymphomas(StiL) non-Hodgkin lymphoma (NHL)-1 trial suggested that bendamustine plusrituximab were superior in effectiveness and tolerability compared to R-CHOPin the treatment of indolent and mantle cell lymphomas. Preliminary studyhas indicated the effective use of bendamustine alone or in combination inthe treatment of aggressive B-cell lymphomas as well. A 70-year-old malewith heavily treated relapsed diffuse large B-cell lymphoma (DLBCL) showedcomplete remission (CR) after receiving 8 cycles of rituximab in combinationwith bendamustine as 3rd line treatment. Bendamustine has demonstratedconsiderable efficacy and well-tolerated therapy in relapsed DLBCL patients.Our case report demonstrated that treating patients with bendamustinebasedregimen, even in the setting of organ impairment and elderly is safeand effective. Given the increasing evidence of its effectiveness, furtherinvestigation of bendamustine’s safety and tolerability aspects in specialgroups is recommended such as those with renal impairment.
Basal-Like Subgroup is Associated with Younger Age, Increased Expression of Androgen Receptor, and Worse Prognosis, while Non-basal-like Subtype is Associated with Higher BMI in Triple-Negative Breast Cancer Patients Ibnu Purwanto; Didik Setyo Heiyanto; Ahmad Ghozali; Irianiwati Widodo; Iwan Dwiprahasto; Teguh Aryandono; Sofia Mubarika Haryana
The Indonesian Biomedical Journal Vol 12, No 4 (2020)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v12i4.1289

Abstract

BACKGROUND: Triple-negative breast cancer (TNBC) represents a heterogenous disease which differ in characteristic, treatment response and prognosis. We aim to perform in-depth analysis on the clinicopathologic feature and the prognostic value of basal-like and non-basal-like TNBC patients in an Indonesian tertiary hospital.METHODS: We retrospectively included patients diagnosed with TNBC between 2014-2017. Clinical variables were collected from medical record. Expression of epidermal growth factor receptor (EGFR), cytokeratin 5/6 (CK5/6), p53 mutant and androgen receptor (AR) were examined by using immunohistochemistry (IHC).RESULTS: We included 67 subjects, 67.1% were basal-like and the remaining 32.9% were non-basal-like, with mean age of 51 years old, 59.7% subjects had BMI <25 and 40.3% subjects had BMI ≥25; 16.4%, 65.7%, and 17.9% subjects presented with early stage, locally advanced stage, and distant metastasis respectively; T<5 cm was found in 29.9% subjects, while 70.1% subjects had T≥5; 67.2% subjects presented with N-, while 32.8% subjects were N+. The most common histological type was infiltrating ductal (82% of subjects). P53 mutant and AR expressions were positive in 44.8% and 15% subjects, respectively. Basal-like subtype presented with younger age at and had higher expression of AR, while non-basal-like subtype is associated with BMI ≥25 (p<0.05). Basal-like subjects had shorter overall survival (23.9 months (95% CI: 21.9-25.9) vs. 26.1 months (95% CI: 23-29.2).CONCLUSION: Basal-like subtype is associated with worse prognosis, younger age at diagnosis and increased expression of AR, while non-basal-like subtype is associated with higher BMI in Indonesian TNBC.KEYWORDS: TNBC, subtype; basal-like, young age, Indonesia
Co-Authors A. Harijadi Agus Barmawi Ahmad Ghozali Ahmad Ghozali Chofi Qolbi NA Diah Ari Safitri Didik Setyo Heiyanto Eiji Tatsumi Hiroyuki Sakoda Irianiwati Widodo Iwan Dwiprahasto Iwan Dwiprahasto Johan Kurnianda Kaho Furuta Kartika W. Taroeno-Hariadi Kartika Widayati Taroeno Hariadi Katsuyasu Saigo Kayoko Masuda Ken-Ichi Nagai Mardiah Suci Hardianti Mardiah Suci Hardiyanti Maryatun Hasan Meilani Syampurnawati Merari Panti Astuti NEVIATY PUTRI ZAMANI Puntodewo Puntodewo Sagiri Mangunsudirjo Seiji Kawano Setsuki Isono Shin-Ichi Kondo Shunichi Kumagai Sofia M. Haryana Sofia Mubarika Haryana Sukendro Sendjaja Sunggoro, Agus Jati Takayuki Takahashi Teguh Aryandono Trisnawati, Lidwina Tika Vita Yanti Anggraeni Wiwiek Probowati Yoshitaka Hayashi