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All Journal Indonesian Journal of Cancer Paediatrica Indonesiana Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Journal of Cancer
Agus Susanto Kosasih, Agus Susanto
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Immunophenotyping in the Diagnosis and Classification of Acute Leukemia: "Dharmais" Cancer Hospital Experience Kosasih, Agus Susanto; Setiawan, Lyana; Hartini, Sri
Indonesian Journal of Cancer Vol 5, No 1 (2011): Jan - Mar 2011
Publisher : "Dharmais" Cancer Center Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (74.918 KB)

Abstract

Penentuan imunofenotipe merupakan salah satu pemeriksaan yang disyaratkan dalam diagnosis dan klasifikasi leukemia. Dalam tulisan ini, kami melaporkan data peranan penentuan imunofenotipe dalam diagnosis leukemia akut dikaitkan dengan pemeriksaan sitomorfologi dan pemeriksaan sitokimia Sudan Black B (SBB) yang dilakukan di Laboratorium Patologi Klinik Rumah Sakit Kanker “Dharmais” (RSKD) sejak Januari 2005 sampai Desember 2007.Menurut imunofenotipe, kami menemukan 13 kasus leukemia limfoblastik akut (LLA) galur T, 82 kasus LLA galur B, dan 110 kasus leukemia mieloblastik akut (LMA). Ko-ekspresi antigen dari galur lain ditemukan pada 38% kasus LLA-T, 28% kasus LLA-B, dan 37% LMA. Antigen limfoid yang paling sering ditemukan ekspresinya pada LMA adalah CD19 diikuti CD7.CD33 ditemukan pada 94,6% kasus LMA dan CD13 pada 87,8% kasus LMA. CD19 ditemukan pada 96% LLA-B, CD10 pada 68% kasus, diikuti CD20 (50%) dan CD22 (33%). CD7 ditemukan pada 92% LLA-T, dan CD3 positif pada 85% kasus LLA-T.Disimpulkan bahwa penentuan imunofenotipe sangat bermanfaat dalam penentuan diagnosis galur, membedakan antara LLA dan LMA, khususnya pada kasus dengan SBB negatif seperti pada kasus LMA-M0 dan M5a, membedakan LLA-B dan LLA-T, serta mendiagnosis kasus leukemia bifenotipe/leukemia galur campuran.Kata kunci: Leukemia akut, imunofenotipe, galur myeloid, LLA-B, LLA-T.
Unveiling the Survival Gap: Addressing the Challenges of Acute Lymphoblastic Leukemia in Adolescents Aisyi, Mururul; Kosasih, Agus Susanto; Utomo, Ahmad Rusdan Handoyo; Saputra, Fahreza; Sari, Teny Tjitra; Sjakti, Hikari Ambara; Dwijayanti, Fifi; Harimurti, Kuntjoro; Andriastuti, Murti
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1396

Abstract

Background: Acute Lymphoblastic Leukemia (ALL) remains the most common pediatric cancer, yet survival outcomes vary widely across age groups. In Indonesia, comprehensive data on ALL survival rates are sparse, particularly for adolescents who often fare worse than younger children. The underlying factors contributing to the difference in adolescent survival rates still need to be fully understood. This study aimed to evaluate and compare the survival rates of children and adolescents with ALL treated at Dharmais Cancer Hospital.Method: We conducted a retrospective cohort analysis of 94 ALL patients, including 37 adolescent patients and 71 patients with B-lineage ALL. All patients with ALL from 2021 to 2023 were identified. Children aged 1–18 years, diagnosed with ALL based on bone marrow results and not yet treated, are included in the study. Patients were stratified by risk stratification (Standard Risk [SR] vs. High Risk [HR]), lineage (B-lineage vs. T-lineage), and age group (children under 10 vs. adolescents 10 years and above). The survival curve was analyzed using the KaplanMeier method, and the log-rank test was used to assess and compare survival across groups.Results: The overall survival (OS) rate for ALL patients was 49.5%. Adolescents had a significantly lower OS rate of 23.2% compared to children. SR patients exhibited an OS rate of 95.7%, while HR patients had a 33.3%. B-cell lineage had a higher OS rate (59.8%) than T-cell lineage (15.9%). In B-cell ALL, OS was 61.4% in children but only 28.1% in adolescents. Conclusion: The survival rate for adolescents with acute lymphoblastic leukemia (ALL) is significantly lower than that of children, influenced by risk stratification, lineage, and age. Further research is needed to identify these risk factors through genetic and molecular analyses.Conclusion: The survival rate for adolescents with acute lymphoblastic leukemia (ALL) is significantly lower than that of children, influenced by risk stratification, cell type, and age. Unexplained factors, including lineage differences, remain a challenge in adolescents. Further research into genetic and molecular factors is essential to enhance treatment precision and improve survival rates for ALL patients in Indonesia, especially adolescents.Keywords: Overall Survival, Leukemia, Adolescent ALL, Stratification
Associations between genomic copy number alterations and clinical and laboratory results in pediatric B-cell acute lymphoblastic leukemia Aisyi, Mururul; Andriastuti, Murti; Kosasih, Agus Susanto; Utomo, Ahmad Rusdan Handoyo; Saputra, Fahreza; Sari, Teny Tjitra; Sjakti, Hikari Ambara; Dwijayanti, Fifi; Harimurti, Kuntjoro
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.89-95

Abstract

Background Copy Number Alterations (CNAs) are changes in DNA structure that lead to gain or loss of copies of DNA sections in the genome. They correlate with unfavorable prognostic outcomes in pediatric leukemia, influencing treatment resistance, relapse rates, and overall survival. Identifying high-risk patients with a likelihood of CNA positivity is essential for understanding its association with clinical characteristics and laboratory findings. Since routine CNA testing is costly, recognizing simple clinical and laboratory markers that predict CNA presence can help focus screening efforts, enabling more efficient risk stratification and prognosis assessment in acute leukemia Objective To describe the characteristics and analyze for associations between CNA, clinical characteristics, and laboratory findings in pediatric ALL patients. Methods This cross-sectional observational study included B-cell acute lymphoblastic leukemia (ALL) patients from three hospitals, excluding those above 18 years. Data collected encompassed demographics, clinical features, and laboratory results. We performed multiplex ligation-dependent probe amplification (MLPA) testing to identify CNA positivity. Results From January to December 2019, there were 74 pediatric ALL patients incuded in our study; 26 of them had positive results and the remaining 48 had negative results. CNA-positive status was commonly found in subjects aged ? 5 years (38.6%), while CNA-negative status was highest in patients aged ? 10 years (72.7%). CNA-positive status was significantly higher in patients with lymphadenopathy, lower hemoglobin level (7.73 g/dL), and lower platelet level (52,019/µL) (P<0.05). Conclusion Patients with lymphadenopathy, lower hemoglobin, and lower platelet levels are more likely to test positive for CNA. However, more research is needed to fully understand the implications of this finding and its potential impact on patient care.
Simultaneous Presentation of Follicular Lymphoma and Diffuse Large B-cell lymphoma (DLBCL): A Case Report Handayani, Rosmeri; Kosasih, Agus Susanto
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1364

Abstract

Introduction: The natural history of follicular lymphoma (FL) is frequently characterized by transformation to a more aggressive diffuse large B-cell lymphoma (DLBCL). Outcomes of patients with histologic transformation (HT) of FL have been believed to be poor. However, a leucocytosis at presentation is infrequently described. In this report, we present a case of simultaneous presentation of follicular lymphoma and DLBCL.Case Presentation: A 50-year-old male patient presented to a head and neck specialist with complaints of slowly progressing swelling in the nose on the left side for a duration of 1 year, diagnosed with nasofarynx carcinoma. After excision surgery, the patient was referred to an internist for follow-up on the leukocytosis. Biopsy and immunohistochemistry from the nose and tonsil were suggestive of DLBCL. However, bone marrow aspiration was suggestive of follicular lymphoma. After a complete work-up, he was diagnosed with DLBCL and was treated with six cycles of the standard (CHOP) regimen. The patient’s history revealed a leukocytosis for 4 years prior to cardiac catheterization.Conclusion: These findings suggest a clonal relationship between the two types of lymphoma cells. Furthermore, they support the transformation of an acute follicular lymphoma into a composite lymphoma combining a high-grade B-cell lymphoma. Understanding the natural history of follicular lymphoma can aid the diagnosis and implies a worse prognosis in patients compared to de novo DLBCL.
Atypical Plasmacyte Morphology in Primary Plasma Cell Leukemia Kosasih, Agus Susanto; Sukartini, Ninik
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2378

Abstract

Plasma cell leukemia (PCL) is a scarce hematology malignancy with challenging clinical picture and dismal prognosis. The diagnostic procedure is sometimes complicated and difficult due to its scarcity. Patient was a 54-year-old male who presented with generalized weakness 2 months prior to hospital admission. He had anemia, thrombocytopenia and leukocytosis with 96% blasts. Initial peripheral blood smear showed unspecific cells that turned out to be plasmacytes. Flow cytometry showed positive for CD38, CD138, Kappa, CD43 and CD200, with conclusion of myeloma. Confirmation with serum protein electrophoresis showed gamma migrating paraprotein with 35.5% gamma Ig G, reduced albumin fraction and alpha 1 globulin. There was M-spike on gamma globulin. Serum immunofixation electrophoresis (SIFE) on the next day showed oligoclonal gammopathy (bi-clonal IgG Kappa and monoclonal Kappa light chain). Based on those results, patient was diagnosed with primary plasma cell leukemia. Diagnosis of PCL is often challenging and misleading due to the clinical features resembling multiple myeloma and unspecific morphology of plasma cell. Peripheral plasmacyte >5% with M-spike on gamma globulin in SPE and gammopathy oligoclonal in SIFE (bi-clonal IgG Kappa and monoclonal Kappa light chain) were supported the diagnosis of PCL and confirmed by the positive flow cytometry for CD38, CD138, Kappa, CD43 and CD200. Therefore, utilization of modern diagnostic procedures like flow cytometry is crucial to make the diagnosis of this rare disease
VALIDATION OF HIV VIRAL LOAD Bioneer AccuPower® HIV-1 Quantitative RT-PCR Kit Compare to Roche-Cobas®4800 System HIV-1 Maskito, Veronika Juanita; Kosasih, Agus Susanto; Sugiarto, Christine
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2418

Abstract

The Bioneer AccuPower®HIV-1 Quantitative renewed the LoD from 38 IU/mL to 33 IU/mL. Performance evaluation of the kit has not been carried out in Indonesia since the alteration, as it is expected that the new kit will have improved sensitivity. This study is a cross-sectional evaluation of the correlation, sensitivity, and specificity of the Bioneer-AccuPower HIV Quantitative RT-PCR Kit compared to the Roche-Cobas 4800 System HIV-1. We obtained venous EDTA plasma from 211 HIV patients tested in the Clinical Pathology Laboratory of Dharmais Hospital, Indonesia. Subject werw  71 high-viral-load samples (>1000 copies/mL), 60 low-viral-load samples (<1000 copies/mL), and 80 undetectable-viral-load samples (<14.2 copies/mL/<24.42 IU/mL). Exclusion criteria were samples under the limit of quantification of each instrument (Roche-Cobas®4800 20 copies/mL (34.4 IU/mL); Bioneer-AccuPower 69.4 copies/mL (49.97 IU/mL)). Ethical Declaration released by Dharmais Hospital Ethical Committee No.DP.04.03/11.7/0872024. The categorical contingency correlation in determining whether the HIV viral load sample was high, low, or undetectable was 0.863. The sensitivity, specificity, and accuracy of the Bioneer-AccuPower HIV Quantitative RT-PCR Kit, compared to the Roche Cobas 4800 System HIV-1, in quantifying HIV viral load were 99.15%, 96.25%, and 98.10%, respectively. Regarding the limit of quantification of each instrument, the Bioneer-AccuPower HIV Quantitative RT-PCR Kit performed well in determining HIV RNA viral loads, making it suitable for HIV screening. It exhibits a strong correlation compared to the Roche Cobas® 4800 System HIV-1. However, it required a larger study that did not limit the sample according to the limit of quantification of both instruments and sequenced the discrepancy samples.
Co-Authors Christine Sugiarto, Christine Fifi Dwijayanti Handayani, Rosmeri Hikari Ambara Sjakti, Hikari Ambara Kuntjoro Harimurti Lyana Setiawan Maskito, Veronika Juanita Murti Andriastuti, Murti Mururul Aisyi Saputra, Fahreza Sri Hartini Sukartini, Ninik Teny Tjitra Sari, Teny Tjitra Utomo, Ahmad Rusdan Handoyo