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All Journal Indonesian Journal of Cancer Chemoprevention Indonesian Journal of Cancer JFIOnline Jurnal Ilmu Kefarmasian Indonesia Journal of Stem Cell Research and Tissue Engineering Cermin Dunia Kedokteran Indonesian Journal of Cancer eJournal Kedokteran Indonesia Makara Journal of Health Research Jurnal Penyakit Dalam Indonesia
Cosphiadi Irawan
Divisi Hematologi Onkologi Medik, Departemen Ilmu Penyakit Dalam, RSUPN Dr. Cipto Mangunkusumo, Fakultas Kedokteran Universitas Indonesia, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Engineering Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Veterinary

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Outcome Result of Acute Myeloid Leukemia Undergoing Treatment in Semi-Isolation Chemotherapy Ward Irawan, Cosphiadi; Steven, Ricci; Gunarsa, Ralph Girson; Tenggara, Jeffry Bela
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 3
Publisher : UI Scholars Hub

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Abstract

Introduction. Standard positive pressure isolation room is not yet widely available in Indonesia. In several private hospitals, current best practice is admitting patients to semi-isolation room with additional protective measures. Despite the limitation, this practice is considered safe and might benefit Acute Myeloid Leukemia (AML) patients. This study aimed to analyze the leukemic profile and survival in AML patients admitted to semi-isolation room. Methods. A retrospective cohort study was conducted using secondary data from medical record of AML patients diagnosed in Mochtar Riady Comprehensive Cancer Center between 2018 – 2020. Patients were divided into semi-isolation room group and not admitted to semi-isolation room group. Semi-isolation room patients who received standard chemotherapy regimen were further analyzed according to complication, outcome, and survival.Results. We included 45 AML patients, 53.3% were females, 42.2% in the 40-59 years age group, and 28.9% were AML-M2. Fifteen patients received standard chemotherapy regimen including D3A7, FLAG, ATRA-Daunorubicin-Cytarabine in semi-isolation room, 60% of them had complete remission after treatment completion. Patients who not admitted to semi-isolation room received conservative treatments including hydroxyurea, mercaptopurine, cytarabine cytoreduction, and decitabine. Among patients in semi-isolation room, 41.2% had sepsis and 29.4 % had septic shock, with most of the sources coming from bloodstream infection (80%), Acinetobacter baumannii remained the most prevalent microorganism. Treatment outcomes showed median Progression Free Survival (PFS) of 11 months, 1-year survival was 47%, and 2-year survival was 27%.Conclusions. In countries with limited standard isolation room, treatment of AML patients in semi-isolation room with infection control protocol could be considered in order to give the standard induction chemotherapy regimen. Although there was an infection risk, strict isolation policy produced good response (60% complete remission).
Neutrophil Lymphocyte Ratio, Three Year Survival of Locally Advanced and Advanced Nasopharyngeal Carcinoma Cahyanur, Rahmat; Nufus, Hayatun; Irawan, Cosphiadi
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 3
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Introduction. Nasopharyngeal carcinoma (NPC) is the most prevalent head and neck malignancy in Indonesia, as NPC-related mortality in Indonesia is the second-highest in Asia after China. Inflammation has been studied to be associated with cancer progression. Neutrophil lymphocyte ratio describes the balance between the unfavorable suppression of immune response against cancer by neutrophils and the beneficial effect of adaptive immunity by lymphocytes. This study aimed to determine the relationship between NLR and the survival of locally advanced and advanced NPC patients.Methods. A retrospective cohort study was conducted using the medical records of NPC patients treated at the hematology clinic RSCM from 2015 to 2018. The difference in 3-year survival between NPC patients with and without metastasis, also high and low NLR, was analyzed with the Kaplan-Meier method. At the same time, multivariate Cox regression analysis was used to obtain adjusted hazard ratios (HR) after comparing with patients’ age, gender, T stage, N stage, NLR level, and metastasis status.Results. There were 143 patients included in this study; a total of 49 (34.3%) had metastasis. There was a significant difference in survival between those with and without metastasis (p=0.001), with 3-year survival of 24.5% in patients with metastasis. The AUC of NLR was 0.600 (CI 95% 0.502—0.698; p=0.049). The optimal cut-off value determined for NLR was 4.7 with a sensitivity of 56.00%, specificity of 62.37%, PPV of 59.81%, and NPV of 58.64% in predicting survival. Based on that value (≥4,7), there was a significant difference in proportion between those with and without metastasis (63.3% vs. 33.0%, p=0.001). Multivariateanalysis showed that metastasis (HR 3.349, CI 95% 1.909—5.874, p<0.001) was associated with poorer survival.Conclusions. There was no association between NLR and 3-year survival in NPC patients. The proportion of subjects with high NLR was found higher in those with metastasis. Metastasis status was associated with 3-year survival.
Immunohistochemistry Profile of Breast Cancer Patients that Get Anthracyclin–Based Chemotherapy in RSUD Kota Bogor Robinson, Marthino; Atmakusumah, Tubagus Djumhana; Irawan, Cosphiadi; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 4
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Introduction. Breast cancer is the most prominent cancer and causing death in women. Treatment of breast cancer requires immunohistochemistry (IHC) to determine prognostic and predictive and imaging tests to determine staging. However, currently in Indonesia only 17 hospital can conduct IHC test. RSUD Kota Bogor like other Type B Hospital have no IHC test facilities. To fullfil that test, its important to refer patient to referal hospital. Because of limitation there are patients who did not do IHC test and continued get anthracycline chemotherapy. The objective of this research is to find out immunohistochemistry profile of breast cancer patients who received anthracycline-based chemotherapy in RSUD Kota Bogor. Methods. A descriptive retrospective study by collecting the breast cancer patients medical records was done since January 2014 to December 2017 in RSUD Kota Bogor. Results. Total of 174 subjects were include in this study which consist of 84 subjects (48%) with IHC test and 90 subjects (52%) without IHC test. The immunohistochemistry profile of breast cancer patients who received anthracycline-based chemotherapy since January 2014 to December 2017 in RSUD Kota Bogor were luminal type (64%), HER2-enriched (18%), and TNBC (18%). Conclusion. Luminal type is the most molecular subtypes in breast cancer patients who received anthracycline-based chemotherapy in RSUD Kota Bogor. However, because of limitation, since January 2014 to December 2017 only 48% of breast cancer patient that get anthracyclin chemotherapy who got IHC test in RSUD Kota Bogor.
Penilaian Domain Pengkajian Paripurna Pasien Geriatri (P3G) sebagai Faktor yang Berpengaruh terhadap Kejadian Pneumonia Nosokomial pada Pasien Usia Lanjut yang Dirawat di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Victor, Hildebrand Hanoch; Wahyudi, Edy Rizal; Rumende, C. Martin; Soejono, C. H.; Rooshoeroe, A. G.; Shatri, Hamzah; Nainggolan, Leonard; Irawan, Cosphiadi
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 1
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Introduction. Nosocomial pneumonia is a lung infection that occurs after the patient is hospitalized for more than 48 hours, without any signs of pulmonary infection at the time of treatment. When compared with young individuals, elderly individuals are more likely to have community-sourced and nosocomial infections with worse outcomes. Comprehensive Geriatric Assessment (CGA) domains are expected to explain the factors that contribute to nosocomial pneumonia in elderly patients. This study aimed to determine the proportion of elderly treated at Dr. Cipto Mangunkusumo National Central General Hospital who experienced nosocomial pneumonia and whether the CGA domains influence the occurrence of nosocomial pneumonia. Methods. A retrospective cohort study was conducted by analyzing the medical records of patients aged 60 years or older who were hospitalized in the medical ward of Geriatric Internal Medicine at Dr. Cipto Mangunkusomo National Central General Hospital in January – September 2019. We also collected secondary data from the geriatric division’s research. The sample consisted of inpatients aged ≥60 years who were hospitalized for more than 48 hours. Those who died within the first 48 hours of hospitalization and subjects with incomplete CGA domain data were excluded from the study. The criteria for nosocomial pneumonia used in this study followed the CDC’s pneumonia criteria for geriatric patients. Data processing was conducted using the application of Statistical Product and Service Solutions (SPSS) 16. Results. Of 228 subjects, the proportion of nosocomial pneumonia in elderly patients hospitalized was 31,14%. The mean age was 69 years with the subject’s age range between 60-89 years. Nutritional status (OR 2.226; CI95% 1.027-4.827) and functional status (OR 3.578; 95%CI 1.398-9.161) are factors that influence the incidence of nosocomial pneumonia in elderly patients who are hospitalized at Dr. Cipto Mangunkusumo National Central General Hospital. Conclusions. The proportion of elderly patients with nosocomial pneumonia was 31.14%. Nutritional status and functional status are factors that influence the incidence of nosocomial pneumonia in elderly patients who are hospitalized at Dr. Cipto Mangunkusumo National Central General Hospital. Keywords: Comprehensive geriatric assessment, elderly, nosocomial pneumonia
ADIPOSE-DERIVED STEM CELL THERAPY ON NON-COMMUNICABLE DISEASE: A SYSTEMATIC REVIEW Tandarto, Kevin; Purwoko, Reza Yuridian; Oktarina, Caroline; Jonlean, Reganedgary; Irawan, Cosphiadi; Abdullah, Murdani; Pawitan , Jeanne Adiwinata
Journal of Stem Cell Research and Tissue Engineering Vol. 7 No. 1 (2023): JOURNAL OF STEM CELL RESEARCH AND TISSUE ENGINEERING
Publisher : Stem Cell Research and Development Center, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jscrte.v7i1.40636

Abstract

The increasing number of non-communicable diseases demands practical therapy innovations, including adipose-derived stem cell application. This study aimed to analyze the effectiveness of adipose stem cell therapy on non-communicable disease patients. The method used in this study was a systematic review according to PRISMA 2020 guidelines. The database search was done on PubMed, Google Scholar, Proquest, and the EBSCO host database between 2016 and 2021. ROBINS-I tool and RoB-2 were used to assess the risk of bias in the clinical trial study. The first literature search identified a total of 2615 articles. After exclusion for some reason, 6 articles were included in this systematic review study. A total of five studies were included in this study. Based on the risk of bias assessment of the included studies, it was found that all studies had a low risk of bias in all domains. This study showed that the efficacy of adipose-derived stem cell therapy was inconsistent; however, the results were promising. In addition, the results showed that adipose-derived stem cell therapy was safe without significant side effects. Further study was needed to identify therapeutic strategies based on Evidence-based Medicine (EBM).
Stimulation Effect of Exosome From Healthy Sera to Natural Killer (NK) Cells of Hepatocellular Carcinoma Subject In Vitro Deby, Deby; Antarianto, Radiana Dhewayani; Barasila, Atikah Chalida; Irawan, Cosphiadi; Ahani, Ardhi Rahman; Jasirwan, Chyntia Olivia Maurine; Damayanti, Lia; Ritchie, Ni Ken; Aditya, Robby Nur
Indonesian Journal of Cancer Vol 18, No 4 (2024): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i4.1122

Abstract

Background: Hepatocellular carcinoma has a poor prognosis due to limitations of therapy such as late diagnosis, lack of specific biomarkers, and insensitivity to this tumor agent. This study aims to develop immunotherapy using autologous natural killer cells (NK cells) with exosome stimulation for hepatocellular carcinoma patients, addressing treatment limitations.Methods: Experimental research conducted from October 2022 to June 2023 at Universitas Indonesia’s Faculty of Medicine involved three hepatocellular carcinoma patients at Dr. Cipto Mangunkusumo General Hospital in Jakarta, Indonesia. NK cells from hepatocellular carcinoma patients were isolated from peripheral venous blood, and exosomes were isolated from the blood serum of healthy donors. Exosome characterization with a particle size analyzer and flow cytometry. Stimulation of exosomes on NK cells for 24 hours, then evaluation of expression of NKp44, NKp46, NKp30, NKG2D, KIR2D, and NKG2A receptors, as well as perforin and granzyme B expression. Visualization of interactions of NK cells with other mononuclear cell fractions (CD4, CD8, CD11c, and CD19) by immunofluorescence. The study compares stimulated and unstimulated NK cells, analyzing their expression of activated and inhibitory receptors, using either the One-Way Anova parametric test or the Kruskal-Wallis non-parametric test for non-normally distributed data.Results: Particle size 100 nm, negative electric charge, and CD63+CD81+ (double positive) exosome isolated results. There was increased expression of receptors NKp44, NKp46, NKp30, NKG2D, decreased expression of NKG2A, and increased expression of perforin and granzyme B in exosome-induced NK cells. There was no cell interaction in the form of immune synapses between exosome-induced NK cells and other mononuclear cell fractions in hepatocellular carcinoma patients. Conclusions: Induction of exosomes into NK cells of hepatocellular carcinoma patients restores the cytotoxic ability of NK cells
Histodynamics of Natural Killer Cells from a Healthy Donor Exposed to Exosomes from the Blood of Hepatocellular Carcinoma Patients Asrinda, Indria; Antarianto, Radiana Dhewayani; Jusuf, Ahmad Aulia; Ahani, Ardhi Rahman; Jasirwan, Chyntia Olivia Maurine; Ritchie, Ni Ken; Nur Aditya, Robby; Irawan, Cosphiadi
Makara Journal of Health Research
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Background: Hepatocellular carcinoma (HCC) is the leading form of liver cancer and the second leading cause of cancer-related deaths globally. Exosomes in the HCC microenvironment can induce significant changes in natural killer (NK) cells during endocytosis. The present study aimed to distinguish exosomes in the blood of HCC patients, analyze changes in NK cell phenotype, and evaluate peroxidase and toluidine blue staining as alternative methods for observing the changes. Methods: NK cells were collected from healthy donors, and exosomes were extracted from the blood of HCC patients. The exosomes were characterized in accordance with MISEV 2018 guidelines, and NK cells were incubated with HCC-derived exosomes. NK cell phenotype changes were assessed using immunofluorescence, toluidine blue staining, and peroxidase staining. Results: The identified exosomes measured 34.7 nm, had a charge of −4.33 mV, and were positive for CD81+. Changes in NK cell receptor expression following exposure to HCC exosomes were not significant (p > 0.05). Immunofluorescence confirmed exosome endocytosis by NK cells, toluidine blue staining revealed negative metachromasia and peroxidase staining indicated morphological NK cell changes. Conclusions: This study demonstrates that peroxidase and toluidine blue staining are effective for observing exosome endocytosis in NK cells, enhancing our understanding of HCC exosome-NK cell interactions and beneficial in developing future therapeutic strategies targeting the HCC microenvironment.
Clinical Characteristics and Outcomes of Patients with Diffuse Large B-Cell Lymphoma Treated Using R-CHOP Luhuna, Muslimah; Irawan, Cosphiadi; Harahap, Agnes S.; Shatri, Hamzah; Yunir, Em; Sutandyo, Noorwati
eJournal Kedokteran Indonesia Vol. 13 No. 1 (2025): Vol 13, No. 1 - April 2025
Publisher : Faculty of Medicine Universitas Indonesia

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Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma with a fairly high prevalence in Indonesia and a relatively poor prognosis. Addition of rituximab (R) to chemotherapy has led to better efficacy than other regimens in clinical trials. However, data on clinical characteristics and outcomes of patients with DLBCL are scarce. This retrospective cohort study analyzed patients' medical records of DLBCL patients from 2014 to 2021 at dr. Cipto Mangunkusumo National Hospital. Patients’ demographics, clinical characteristics, treatment responses, and 24-month event-free survival (EFS) were assessed using univariate analyses and receiver operating characteristic curves. A total of 100 patients were included, comprising 46% male and 54% female, with the majority (83%) aged <60 years. Complete response (CR) was observed in 44.2% of males and 55.8% of females, while non-complete response (non-CR) occurred in 60% and 40%, respectively. Among patients under 60 years old, CR and non-CR were 92% and 88.4%, respectively. Low and high international prognostic index (IPI) scores accounted for 58.8% and 41.2%, with corresponding CR therapy responses of 27% and 10%, and non-CR therapy responses of 52.9% and 47.1%. The majority of patients were of the non-germinal center B-cell-like (GCB) subtype (81%) compared to GCB (15%), with CR therapy responses of 84.8% and 15.2%, and non-CR therapy responses of 75% and 25%, respectively. The 24-month EFS rate was 68%. The clinical characteristics observed in this study differ from those reported in Western populations, where younger age, female gender, low IPI scores, and non-GCB subtypes were more prevalent. These findings highlight the need for further investigation to understand regional differences in DLBCL better.
Correlation between Plasma Soluble CD36 Levels with Body Mass Index of Breast Cancer Patients in the Indonesian Population Rachman, Andhika; Irawan, Cosphiadi; R.R., Aditia; Koesnoe, Sukamto; Wijaya, Indra
Indonesian Journal of Cancer Chemoprevention Vol 14, No 1 (2023)
Publisher : Indonesian Society for Cancer Chemoprevention

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14499/indonesianjcanchemoprev14iss1pp12-21

Abstract

The cluster of differentiation 36 (CD36) is a multiligand receptor protein that plays a role in lipid metabolism. Its biological functions involve lipid uptake, immune recognition, inflammation, molecular adhesion, and tumor metastasis. Soluble CD36 (sCD36) is the circulating form of CD36 in plasma. Research on the role of sCD36 in breast cancer is limited. This study aimed to investigate sCD36 concentration and evaluate the correlation between sCD36 concentration and BMI in breast cancer patients. This is a multi-center cross-sectional study done from June 2018 to February 2019 in Indonesia. Consecutive sampling was done for women with invasive breast cancer aged 18-70. Patients with locoregional recurrences, multiple comorbidities, diabetes, stroke, or liver impairment were excluded. Patients were grouped based on their BMI into normo-weight and overweight/obese. Plasma sCD36 was analyzed using Bioassay Laboratory™ ELISA. The correlation between plasma sCD36 and the patient's characteristics (metastasis status and molecular subtype) were then analyzed. A total of 76 patients were enrolled, 36 of whom were categorized into the overweight/obese group and 40 of them in the normo-weight. Plasma levels of sCD36 in breast cancer patients were higher than controls at 0.24±0.163 ng/mL and 0.46±0.175 ng/mL, respectively (p=0.006). However, no difference in plasma sCD36 levels was found between the overweight/obese group and the normo-weight breast cancer subjects (p>0.05). Plasma sCD36 increased significantly in breast cancer patients, but no significant difference was found based on body mass index. Further research is needed to determine the role of sCD36 in determining clinical outcomes and prognosis in breast cancer patients.Keywords: Soluble CD36, body mass index, breast cancer, indonesia.
Co-Authors -, Shelly Abdulmuthalib Abdulmuthalib Aditya, Robby Nur Adli, Mizanul Agus Kosasih, Agus Ahani, Ardhi Rahman Ahmad Aulia Aldrat, Hendri Aldrat, Hendri Alida Harahap Andhika Rachman Andy William Andy William Antarianto, Radiana Dhewayani Ardian Saputra, Ardian Aru W Sudoyo Ary H Reksodiputro, Ary H Asrinda, Indria Atmakusumah, Tubagus Djumhana Auda Aziz, Auda Barasila, Atikah Chalida C. Martin Rumende, C. Martin Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Deby Deby Djumhana Atmakusumah, Djumhana E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edy Rizal Wahyudi Em Yunir, Em Endang Hardjolukito Endang Hardjolukito Endang Susalit Endang Susalit Filbert Jayalie, Vito Harahap, Agnes S. Harryanto Reksodiputro Harryanto Reksodiputro, Harryanto Hayatun Nufus Hayatun Nufus HENDRI ALDRAT Idrus Alwi Ika Prasetya Wijaya INDRAYANI, LENNY Jonlean, Reganedgary Leonard Nainggolan Lia Damayanti Lim Weng Kong, Lim Weng Linda Armelia Linda Armelia Linda Lison, Linda Luhuna, Muslimah Lyana Lyana, Lyana Maksum Radji Maksum Radji Marthino Robinson Marthino Robinson Maruhum B.H. Marbun Maruhum Bonar HM, Maruhum Bonar Merry Wintery, Merry Muchtaruddin Mansyur Muhadi Muhadi, Muhadi Murdani Abdullah Ni Ken Ritchie, Ni Ken Noorwati Sutandyo Nur Aditya, Robby Nurjati Chaeranie Siregar, Nurjati Chaeranie Oktarina, Caroline Ong Choon Kiat, Ong Choon Pawitan , Jeanne Adiwinata Purwoko, Reza Yuridian R.R., Aditia Rahmat Cahyanur Rahmat Cahyanur Rahmat Cahyanur Ralph Girson Gunarsa Rianto Setiabudy Ricci Steven, Ricci Rooshoeroe, A. G. Rudi Putranto Shelly - Soejono, C. H. Sri Inggriani, Sri Sukamto Koesnoe Tandarto, Kevin Teguh Santoso Tenggara, Jeffry Bela The Bin Tean, The Bin Tubagus Djumhana Atmakusumah Victor, Hildebrand Hanoch Vito Filbert Jayalie Vivian Soetikno Wijaya, Indra YAHDIANA HARAHAP Yahdiana Harahap