Leukemia Myeloblastik Akut: Luaran Terapi di RSUP DR. Sardjito, Yogyakarta, 2004-2008

SITI AURELIA NURMALASARI, PUDJO HAGUNG WIDJAJANTO, SRI MULATSIH, IGNATIUS PURWANTO

Sub Bagian Hematologi dan Onkologi Instalasi Kesehatan Anak, RSUP DR. Sardjito/Fakultas Kedokteran Universitas Gadjah Mada, Yogyakarta

Diterima 11 Januari 2012; Direview 13 Januari 2012; Disetujui 27 Januari 2012

ABSTRACT

Background The incidence of childhood acute myeloblastic leukemia (AML) had increased for years, but the success of therapy is still low. Objective To analyze overall survival (OS) and prognostic factors of AML in DR. Sardjito General Hospital from January 2004 -December 2008. Methods Patients aged less than 15 years and newly diagnosed as AML included in this study. The prognostic factors such as WBC and nutritional status were recorded. The OS was analyzed using Kaplan-Meier method. Prognostic factors were analyzed using Cox regression. Results Of 56 (63.6%) patients underwent chemotherapy with a modified NOPHO-AML 93 protocol, 19 patients (33.9%) were died, 4 (7%) were relapsed, 32 (57%) were dropped out, and 1 (2%) was survived. Median survival was 3.05 months (10 days - 2.8 years), 3-year overall survival was 19 ± 10%. Conclusion Childhood AML still have poor prognosis in our institution. Progression of disease, drug toxicity, and insufficient supportive care may cause this condition.

Keyword: childhood AML, prognostic factors, overall survival

ABSTRAK

Latar belakang: insiden Leukemia Myeloblastik Akut (LMA) anak meningkat dari tahun ke tahun, namun keberhasilan terapi masih rendah. Tujuan: mengetahui overall survival pasien LMA anak dan faktor prognosis yang mempengaruhi luaran terapi di RSUP DR. Sardjito Yogyakarta, Januari 2004 - Desember 2008. Metode: anak usia < 15 tahun dan baru terdiagnosis LMA dimasukkan dalam penelitian ini. Faktor prognosis meliputi jumlah lekosit saat diagnosis dan status gizi. Analisis overall survival menggunakan metode Kaplan-Meier. Faktor prognosis dianalisis menggunakan regresi Cox. Hasil: terdapat 56 (63,6%) pasien menjalani kemoterapi dengan modifikasi protokol NOPHO-AML 93. Didapatkan 19 (33,9%) pasien meninggal, 4 (7%) relaps, 32 (57%) drop out, dan 1 (2%) survive. Median survival 3,05 bulan (10 hari - 2,8 tahun). Overall survival 3 tahun adalah 19 ± 10%. Kesimpulan: prognosis LMA anak di institusi kami masih buruk. Progresivitas penyakit, toksisitas obat, dan belum memadainya supportive care berperan dalam kematian pasien LMA anak.

Kata kunci: LMA anak, faktor prognosis, overall survival.

Please logon to read / download the full content.

If you do not have an account, you may: