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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) Medical Journal of Indonesia The Indonesian Biomedical Journal Smart Medical Journal

Ibnu Purwanto

Department Of Internal Medicine, Faculty Of Medicine, Universitas Gadjah Mada/ Dr. Sardjito Hospital, Yogyakarta

Author-ID : 349999

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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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)

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)

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)

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.

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

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