Analisis Kemoterapi pada Pasien Tn. “AM” dengan Acute Lymphoblastic Leukaemia (ALL) disertai HIV Positif dan Hepatitis B - Hartati, Hartati (Journal of Experimental and Clinical Pharmacy (JECP), 2023)
Leukemia Limfoblastik Akut (ALL/LLA) adalah proliferasi ganas sel limfoid yang tersumbat pada tahap awal diferensiasi yang dapat menyerang sumsum tulang, darah, dan situs ekstrameduler. Penatalaksanaan leukemia meliputi terapi kuratif dan suportif. Studi kasus ini bertujuan untuk memperoleh gambaran tentang regimen kemoterapi pasien ALL yang disertai Hepatitis B Kronik dan HIV positif. Pengumpulan data menggunakan desain deskriptif dengan metode wawancara serta observasi langsung kondisi pasien dan e-rekam medik, e-resep yang dikaji kesesuaiannya berdasarkan protokol kemoterapi. Berdasarkan sequencing regimen kemoterapi diperoleh bahwa pasien menerima regimen Hyper CVAD dengan nilotinib, dimana penilaian resiko Chemotherapy Induced Nausea Vomiting diperoleh bahwa protokol kemoterapi yang diterima termasuk dalam kategori Moderate Emetogenic. Regimen ini juga disertai dengan pemberian Methotrexate dosis tinggi sebagai profilaksis CNS. Akan tetapi, untuk mengurangi resiko nefrotoksisitas akibat pemberian Methotrexate dosis tinggi, maka diperlukan tambahan natrium bikarbonat dan allopurinol untuk mencegah TLS pada pasien dengan ALL.Acute Lymphoblastic Leukaemia (ALL) is a malignant proliferation of lymphoid cells that are occlude at an early stage of differentiation and can invade the bone marrow, blood, and extramedullary sites. Management of leukemia includes curative and supportive therapy. This case study aims to obtain an overview of the chemotherapy regimen of ALL patients with chronic hepatitis B and HIV. Data were collected in a descriptive design with interview methods and direct observation of patient conditions and e-medical records. E-prescriptions were reviewed for suitability based on chemotherapy protocols. Based on the chemotherapy regimen sequencing, it was found that the patient received the hyper-CVAD regimen with nilotinib, while the chemotherapy-induced nausea and Vomiting risk assessment found that the chemotherapy protocol received was included in the Moderate Emetogenic category. This regimen is also accompanied by the administration of high doses of Methotrexate as CNS prophylaxis. However, to reduce the risk of nephrotoxicity due to the administration of high doses of Methotrexate, it is necessary to add sodium bicarbonate and allopurinol to prevent TLS in patients with ALL.