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Secondary acute myeloblastic leukemia after adjuvant chemotherapy and radiotherapy in breast cancer: A case report Kartika Widayati Taroeno-Hariadi, Mardiah Suci Hardianti, Johan Kurnianda,
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 03 (2014)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/jms.v46i03.7311

A rising number of long-term survivors and potential long-term outcome related to the treatment isone of the most important issue due to the advances of management in cancer. The development ofsecondary malignancy has been reported in a number of cohorts. We present a case of breast cancerpatient developing acute myeloid leukemia (AML)- M5 within a relatively short interval of two and ahalf years from her primary treatment with adjuvant chemotherapy with 4 cycles of doxorubicin andcyclophosphamide, followed by 4 cycles of three weekly paclitaxel (AC-T) and radiotherapy. Whatcould be attributed to the occurrence of secondary leukemia in this patient will be discussed.

Secondary acute myeloblastic leukemia after adjuvant chemotherapy and radiotherapy in breast cancer: A case report Hardianti, Mardiah Suci; Kurnianda, Johan; Taroeno-Hariadi, Kartika Widayati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 03 (2014)
Publisher : Universitas Gadjah Mada

A rising number of long-term survivors and potential long-term outcome related to the treatment isone of the most important issue due to the advances of management in cancer. The development ofsecondary malignancy has been reported in a number of cohorts. We present a case of breast cancerpatient developing acute myeloid leukemia (AML)- M5 within a relatively short interval of two and ahalf years from her primary treatment with adjuvant chemotherapy with 4 cycles of doxorubicin andcyclophosphamide, followed by 4 cycles of three weekly paclitaxel (AC-T) and radiotherapy. Whatcould be attributed to the occurrence of secondary leukemia in this patient will be discussed.

Link of Nasopharyngeal Carcinoma and Epstein-Barr Virus Sugiyanto Sugiyanto; Lina Aryati; Fajar Adi Kusumo; Mardiah Suci Hardianti
Biology, Medicine, & Natural Product Chemistry Vol 7, No 2 (2018)
Publisher : Sunan Kalijaga State Islamic University & Society for Indonesian Biodiversity

Nasopharyngeal Carcinoma (NPC) is a cancer that occurs in nasopharynx which is associated with Epstein-Barr Virus (EBV). Mutation agents in nasopharyngeal neoplasms occur because of EBV infection. Transformation of B-cells due to EBV causes hormone imbalance in lymphoid cells or nasopharyngeal epithelial tissue. Rates of EBV infection have been shown to be prognostic to NPC. The basic level of EBV DNA can be used for stratification prognosis, with higher titers showing greater disease severity and worse outcomes. With mathematical models, there is a correlation between the increase in Epstein-Barr Virus and the increase in Invasive Carcinoma Cells or increase in Nasopharyngeal Carcinoma Cells.

A Stability Mathematical Model of Nasopharyngeal Carcinoma on Cellular Level Sugiyanto Sugiyanto; Fajar Adi Kusumo; Lina Aryati; Mardiah Suci Hardianti
Biology, Medicine, & Natural Product Chemistry Vol 5, No 2 (2016)
Publisher : Sunan Kalijaga State Islamic University & Society for Indonesian Biodiversity

This paper discussed the stability of “Tumorigenesis Models” to link between EBV and carcinoma of the nasopharyngeal from normal cell to invasive carcinoma. The review on this case accomplished the previous theorem of equilibrium point on “Tumorigenesis Models”.

Ex vivo Generation of Platelets from Umbilical Cord Blood Hematopoietic Stem Cells with Amniotic Membrane Mesenchymal Stem Cells Support Mardiah Suci Hardianti
Acta Interna The Journal of Internal Medicine Vol 3, No 1 (2013): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

ABSTRACTBackground: Platelet refractoriness is a major problem among patients requiring repeated transfusion. Production of less immunogenic platelets is required to overcome this problem. Umbilical cord blood (UCB) is rich in hematopoietic stem cells (HSC), which may serve as a potential source of less immunogenic ex vivo generated platelet. Development of methods to generate platelet from HSC in UCB with additions of various growth factors made a very high production cost. Amniotic membrane is widely known as the best source of mesenchymal stem cells (MSC), which may support the growth of platelet from HSC in UCB due to its abundant productions of cytokines and low cost . Aim: This study aimed to generate platelet from UCB co-cultured with MSC derived from amniotic membrane.Methods: Gradient density separation was performed to obtain mononuclear cells from UCB. The resulted mononuclear (MN) cells were selected for CD34+ by magnetic sorter beads. CD34+ HSC and non-CD34+ MN cells were each cultured in standard medium plus 10 ng/ml thrombopoietin (TPO), 50 ng/ml stem cell factor (SCF), and 25 ng/ml interleukin-11 (IL-11), with or without co-cultured with MSC. The MSC was also cultured alone with the addition of the above mentioned cytokines. Cultures were incubated in 37o C with 5% CO2 and half of the medium was changed twice a week. Formations of platelets were confirmed by flowcytometry after two weeks culturing.Results: Total number of CD34+ HSC was 1x106, the non-CD34+ MNC was 1.78x107 and the MSC was 3x105. Following the culture systems, the number of platelets produced from CD34+ HSC with and without MSC were 1.17% and 0.84%, respectively. The numbers of platelets produced from non-CD34+ MN cells with and without MSC were 7.94% and 8.85%, respectively. The number of platelets produced from 105 MSC was 1.43%.Conclusions: There was a greater increment in ex vivo production of platelets in CD34+ HSC isolated from UCB co-cultured with MSC, compared to that of without MSC. Further study to evaluate the significancy of the increament and the platelet function produced by this system is warranted. Keywords: platelet, hematopoietic stem cells, - mesenchymal stem cells

Telomere and telomerase in hematological disorders Focusing on bone marrow failure syndromes and hematological malignancies Mardiah Suci Hardianti; Ibnu Purwanto; Johan Kurnianda
Acta Interna The Journal of Internal Medicine Vol 4, No 2 (2014): The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

ABSTRACTWe review the present knowledge of telomeres and telomerase with special attention to their role in hematological disorders especially bone marrow failure syndromes including acquired aplastic anemia and myelodysplastic syndromes, as well as acute and chronic myeloid leukemia. The current understanding on the role of telomere and telomeres dysfunctions in hematological disorders leads us to a better understanding on the pathology of the diseases as well as considering some possibilities to employ the measurement of telomere length and telomere activity in disease prognostication. Several treatment options targeting telomere and telomerase being developed are also reviewed.Keywords: telomere- telomerase- bone marrow failure syndromes- hematological malignancies

Prolonged Survival in a Non-Small Cell Lung Cancer with Brain Metastasis Treated with a Brain Mass Evacuation and Gefi tinib Mardiah Suci Hardianti; Johan Kurnianda
Acta Interna The Journal of Internal Medicine Vol 5, No 1 (2015): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

The incidence of brain metastasis (BM) is reported to be increase about 20-40% over the last few years in patients with non-small-cell lung cancer (NSCLC).1 The use of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) in NSCLC patients with BM, especially those harboring EGFR mutations have been reported.

Prognostic Value Of Chemotherapy-Induced Neutropenia In Metastatic Colorectal Cancer At Rsup Dr Sardjito Yogyakarta Muhammad Ihsan Qomaruzzaman; Johan Kurnianda; Mardiah Suci Hardianti
Acta Interna The Journal of Internal Medicine Vol 6, No 1 (2016): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Background: Colorectal cancer is the third largest incidence of cancer in the world and is the third most common cause of death in women and men . Five-year overall survival (OS) in colorectal cancer who have undergone metastasis was 10 % . Hematologic toxicity may be a marker of biological activity of cytotoxic drug on various types of cancer . Neutropeniaafter chemotherapy known to be associated with increased patient survival .Objective : To establish whether chemotherapy-induced neutropenia is predictive of better outcome in patients with metastatic colorectal cancer (mCRC).Methods: This research was a case-control study. Subjects were patients with metastatic colorectal cancer in the Cancer Instalation Center Tulip RSUP dr. Sardjito who meet the inclusion and exclusion criteria. Data were analyzed by bivariate analysis using chi square test and multivariate analysis with logistic regression.Results: Neutropenia present in 26 patients (32.5%) of the total 80 patients of the study. Neutropenia were significantly affect OS ( p = 0.001 and OR 7.73, 95% CI: 2.51-23.80). Multivariate logistic regression analysis showed neutropenia and the number of metastases affect OS with p <0.001 and p <0.003.Conclusion: Neutropenia occurring during the two first lines of chemotherapy for metastases colorectal cancer is associated with better survival. Variables that affect OS is the number of metastases and incidence of neutropenia after chemotherapy.

Comparison of Prognostic Scores in Chronic Myeloid Leukemia (Cml) Patients with Bcr-Abl Mutation Types B3a2 and B2a2 in Dr. Sardjito General Hospital Nina Mulyani; Johan Kurnianda; Mardiah Suci Hardianti
Acta Interna The Journal of Internal Medicine Vol 10, No 1 (2020): 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.61296

Background. Chronic Myeloid Leukemia (CML) is a myeloproliperative malignancy that is caused byreciprocal translocation between chromosomes 9 and 22 which form the BCR-ABL fusion gene. Most CML patients have a major type of BCR-ABL mutation. There are b3a2 and b2a2 types, which produce different oncoproteins in 25 amino acid elements. The expression of different proteins is thought to cause differences in clinical manifestations, laboratory, and prognosis. In CML, there are several prognostic scoring systems, including Sokal, Hasford, andEUTOS scores which combine clinical and laboratory parameters. The effect of this genomic breakpoint location on clinical and biological characteristics is still controversial.Aims. The aim of this study was to determine the comparison of prognostic scores between CML patients with b3a2 and b2a2 BCR-ABL mutation types in Dr. Sardjito General Hospital.Methods. This study was a cross sectional retrospective study used secondary data from medical records of Dr. Sardjito General Hospital, from March 2014 to April 2016. The prognostic score of Sokal, Hasford, and EUTOS was calculated in the BCR-ABL mutation type groups b3a2 and b2a2. Data were analyzed by Chi Square test.Results. A total of 113 CML patients were analyzed with 74 (65.5%) b3a2 mutation type groups and 39 (34.5%) b2a2 mutation type groups. Hemoglobin levels, leukocytes, platelets, basophils, and eosinophils did not differ significantly between the two groups of mutation types. Meanwhile, the statistical test for the phase of disease when the patient was first diagnosed in both types of mutations showed a significant difference (p = 0.005). More patients with types of b2a2 mutations came in the acceleration and blast crisis phases than b3a2 types. However, Sokal, Hasford, and EUTOS prognostic scores in the b3a2 mutation type group were not significantly different from the b2a2 group (p> 0.05).Conclusions. There was no significant difference in prognostic scores of CML patients with the b3a2 BCRABL mutation type compared with the b2a2 mutation type in Dr. Sardjito General Hospital Yogyakarta.

Secondary acute myeloblastic leukemia after adjuvant chemotherapy and radiotherapy in breast cancer: A case report Mardiah Suci Hardianti; Johan Kurnianda; Kartika Widayati Taroeno-Hariadi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 03 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

A rising number of long-term survivors and potential long-term outcome related to the treatment isone of the most important issue due to the advances of management in cancer. The development ofsecondary malignancy has been reported in a number of cohorts. We present a case of breast cancerpatient developing acute myeloid leukemia (AML)- M5 within a relatively short interval of two and ahalf years from her primary treatment with adjuvant chemotherapy with 4 cycles of doxorubicin andcyclophosphamide, followed by 4 cycles of three weekly paclitaxel (AC-T) and radiotherapy. Whatcould be attributed to the occurrence of secondary leukemia in this patient will be discussed.

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