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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
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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Penerapan Modalitas Anti-PD-1/PD-L1 pada Pasien KPTN di Indonesia Ibnu Purwanto
Jurnal Kedokteran Syiah Kuala Vol 22, No 1 (2022): Volume 22 Nomor 1 Maret 2022
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jks.v22i1.24785

Abstract

Hingga saat ini tatalaksana KPTN masih belum menghasilkan peningkatan kesintasan yang memuaskan. Jika dibandingkan subtipe KPD lainnya, KPTN bersifat lebih imunogenik dengan ekspresi PD-1/PD-L1 yang lebih tinggi sehingga menjadi kandidat yang baik dalam penggunaan anti-PD-1/PD-L1. Berbagai penelitian telah menunjukan bahwa anti-PD-1/PD-L1 dapat digunakan secara efektif dalam terapi KPTN sebagai kombinasi dengan kemoterapi sistemik, baik dalam seting adjuvan maupun neoadjuvan. Tidak semua anti-PD-1/PD-L1 menunjukan manfaat yang sama dan sejauh ini pembrolizumab merupakan agen anti-PD-1/PD-L1 yang menunjukan respon paling baik pada KPTN. Telaah literatur ini bertujuan untuk merangkum bukti klinis yang ada serta membuat rekomendasi terkait penerapan agen PD-1/PD-L1 dalam manajemen pasien KPTN di Indonesia.
Prognostic Values of Hemoglobin and Red Blood Cell Distribution Width to Overall Survival in Non-Hodgkin Lymphoma Trisnawati, Lidwina Tika; Hardianti, Mardiah Suci; Purwanto, Ibnu
Acta Interna The Journal of Internal Medicine Vol 12, No 2 (2023): 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.98483

Abstract

Background. After the Rituximab era, baseline International Prognostic Index (IPI) is not sufficient for the initial risk stratification of patients with Non-Hodgkin lymphoma (NHL). Low hemoglobin (Hb) levels and high red blood cell distribution width (RDW) baseline are known to be associated with poor outcomes and overall survival in malignancy. This study aimed to evaluate the prognostic value of Hb and RDW to overall survival in NHL patients who undergoing chemotherapy at Dr. Sardjito Hospital.Method. A retrospective cohort study in NHL from patients’ medical records diagnosed from 2014 to 2018 and undergoing chemotherapy at Dr. Sardjito Hospital. The prognostic influence of clinical factors including Hb and RDW on 3 years of overall survival were studied by using Kaplan-Meier curves and univariate Cox regression tests. To evaluate the independent prognostic relevance of basic characteristics data (age, gender, BMI, performance status, Ann Arbor stage, extranodal involvement), Hb, and RDW, multivariate Cox proportional hazards regression was applied. Results. From 292 NHL patients included, the median Hb was 12.7 g/dL and the median RDW was 14.2%. The mean survival time was 31.13 months, 38 patients (13%) died during the 3 years of follow-up. The most common causes of death were sepsis (68.4%) and 12 patients (4.1%) died within <30 days of chemotherapy. Based on Cox regression univariate analysis, patients with lower Hb levels (<10 gr/dL) had a 3-year overall survival lower than Hb>10 gr/dL (71% vs. 87%, CI 95%, p=0.014), with Hazard Ratio 2.49 (p=0.02). Patients with higher RDW>15.5 levels had lower overall survival than patients with RDW<15.5 levels (77.5% vs. 91.1%, CI 95%, p=0.002), and Hazard Ratio 2.78 (p=0.02). Based on multivariate analysis, performance status (OR=2.589, CI 95%, 1.225-5.471, p=0.013) and RDW (OR=2.292, CI 95%, 1.106-4.48, p=0.026) are independent predictor factors of 3-year overall survival.Conclusion. NHL patients with lower Hb and higher RDW levels have lower 3-year overall survival.
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