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Implementing Yogyakarta Pediatric Cancer Registry for 16 years Sri Mulatsih; Adnina Hariningrum; Ignatius Purwanto; Rizki Oktasari
Paediatrica Indonesiana Vol 59 No 4 (2019): July 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (815.945 KB) | DOI: 10.14238/pi59.4.2019.188-94

Abstract

Background A hospital-based cancer registry can be used as a guide to decision-making. Considering the limited cancer registry data in the population, the Yogyakarta Pediatric Cancer Registry (YPCR) is one of the pioneers of hospital-based pediatric cancer registries in Indonesia. The YPCR was started in 2000 in Dr. Sardjito Hospital. Objective To describe the characteristics of childhood cancer and the outcomes by analyzing overall survival (OS) and event-free survival (EFS) based on data from Yogyakarta Pediatric Cancer Registry. Methods Data were collected from the YPCR for the period of 2000 to 2016. Childhood cancers were classified into 12 groups based on the 3rd edition International Classification for Childhood Cancer (ICCC). Incidence, frequency, and distribution of cases were grouped by sex, age, and patients’ place of residence. Incidence was further analyzed using SPSS software. Kaplan-Meier test was used to analyze OS and EFS. Results Within the study period, 2,441 children aged 0-18 years were diagnosed with cancer. The highest incidence was found in the 1-5-year age group. The most common diagnoses found were leukemia, myeloproliferative disorders, and myelodysplastic disease (58%); lymphoma and reticuloendothelial neoplasm (8%); retinoblastoma (6%); soft tissue and other extra-osseous sarcomas (5%); as well as neuroblastoma and other peripheral nervous cell tumors (5%). The OSs of acute lymphoblastic leukemia (ALL), high risk ALL (HR-ALL), and standard risk (SR-ALL) were 31.8%, 18.5%, and 43.9%, respectively. The EFSs of ALL, HR-ALL, and SR-ALL were 23.9%, 14.7%, and 32.4%, respectively. For solid tumors, the OS was 13.7% and EFS was 6.4%. Conclusion The number of new cases of childhood cancer has increased in the last few years. The Yogyakarta Pediatric Cancer Registry (YPCR), which serves as a hospital-based pediatric cancer registry, has an important role to evaluate clinical and non-clinical aspects of childhood cancer.
Cumulative cyclophosphamide dose and serum anti-Mullerian hormone levels in adolescent cancer survivors in Indonesia Sri Mulatsih; Sarrah Ayuandari; Naafi Rizqi Rahmawati; Rizki Oktasari; Agung Dewanto
Paediatrica Indonesiana Vol 63 No 5 (2023): September - October 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background As both the prevalence and survival rates of cancer in children and adolescents has risen, longer-term effects of cancer treatment must be investigated. High-risk gonadotoxic chemotherapeutic agents such as cyclophosphamide may affect the ovarian reserve and impact female adolescent fertility. Anti-Mullerian hormone is a reliable marker to assess ovarian reserve. Objective To assess for a possible correlation between the cumulative dose of cyclophosphamide and serum anti-Mullerian hormone (AMH) levels among adolescent cancer patients. Methods This cross-sectional study included 12-18-year-old adolescent female cancer patients who had experienced menarche and received cyclophosphamide therapy. We recorded the patients’ full history, including menstrual history, computed the cumulative dose of cyclophosphamide received, and measured serum AMH levels. The correlation test was performed to evaluate for a possible correlation between the cumulative dose of cyclophosphamide and ovarian reserve as represented by AMH levels. Results Out of 12 female adolescent cancer patients, three complained of disturbances in their menstrual cycles. Low levels of AMH (<1.5 ng/mL) were noted in five patients. Median cumulative cyclophosphamide dose was 1,000 mg/m2 (range 1,000 to 5,250 mg/m2). Cumulative cyclophosphamide dose was negatively correlated with serum AMH levels, but this correlation was not statistically significant (r=-0.316, P=0.318). Conclusion This study has not been able to show a correlation between cumulative cyclophosphamide dose and serum AMH level. Regular evaluation of fertility and involvement of fertility team is recommended in adolescents receiving high-risk gonadotoxic chemotherapeutic agents.