Wulyo Rajabto
Department Of Internal Medicine, Hematology Oncology Division, CiptoMangunkusumo National Hospital, Jakarta, Indonesia

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Mycophenolate mofetil versus cyclophosphamide for therapy of lupus nephritis: an evidence-based case report from systematic reviews and meta-analyses Sukmana, Nanang; Siregar, Parlindungan; Rajabto, Wulyo; Karim, Birry; Pramono, Laurentius A.; Setyohadi, Bambang
Medical Journal of Indonesia Vol 21, No 1 (2012): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (402.305 KB) | DOI: 10.13181/mji.v21i1.474

Abstract

Background: The aim of this case study is to compare the effectiveness between cyclophosphamide and mycophenolate mofetil to achieve remission of lupus nephritis in an evidence-based case report from meta-analyses.Methods: Method in this case study is evidence-based case report using meta-analyses. Clinical question used in this paper is; which immunosuppressant gives better result in achieving remission in lupus nephritis patient: cyclophosphamide or mycophenolate mofetil? To answer this question, we search the evidence from PubMed with the keywords: “lupus nephritis AND mycophenolate mofetil AND cyclophosphamide” with inclusion criteria of meta-analysis, written in English, and focused comparing cyclophosphamide and mycophenolate mofetil.Results: From the searching method, we found 11 articles which is relevant. One has been excluded since it written in Hebrew, 4 articles excluded since are not focus answering the clinical question. At the end, 6 studies were included to the critical appraisal step.Conclusion: Based on the evidences, mycophenolate mofetil is non-inferior to cyclophosphamide in achieving remission in lupus nephritis patients, but with the better safety profile. Patient in our case study get mycophenolate mofetil and shows better clinical condition towards remission as she are evaluated in the outpatient clinic. (Med J Indones 2012;21:44-51)Keywords: Cyclophosphamide, evidence-based case report, lupus nephritis, meta-analysis, mycophenolate mofetil, remission, systematic review
Profil Pasien Anemia Hemolitik Auto Imun (AHAI) dan Respon Pengobatan Pasca Terapi Kortikosteroid di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo Rajabto, Wulyo; Atmakusuma, Djumhana; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol 3, No 4 (2016)
Publisher : Jurnal Penyakit Dalam Indonesia

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

Abstract

Pendahuluan. Anemia hemolitik auto imun (AHAI) merupakan salah satu penyakit imunologi yang menyebabkan hemolisis. Data mengenai karakteristik demografi dan respon pengobatan AHAI, khususnya pemberian kortikosteroid belum banyak didapatkan di Indonesia. Penelitian ini dilakukan untuk mengetahui profil pasien-pasien AHAI dan respon pengobatannya setelah mendapatkan kortikosteroid. Metode. Desain studi potong lintang dilakukan menggunakan status rekam medik pasien AHAI yang berobat jalan di Poliklinik Hematologi-Onkologi Medik Departemen Ilmu Penyakit Dalam RSUPN Dr. Cipto Mangunkusumo selama 5 tahun (2004- 2008). Variabel yang diteliti meliputi karakteristik demografi, klasifikasi AHAI dan etiologinya, serta respon pengobatannya setelah mendapatkan kortikosteroid dosis inisial setara prednison 1-1,5 mg/kgbb/hari selama 3-4 minggu, respon positif ditandai oleh meningkatkan kadar Hb ≥10 g/dL. Hasil. Dari total 50 subjek, didapatkan 92% AHAI tipe hangat, 6% tipe dingin dan 2% campuran. Etiologi AHAI tipe hangat adalah idiopatik atau primer (54,3%), sedangkan etiologi tipe sekunder adalah lupus eritematosus sistemik/LES (41,3%), hepatitis autoimun (2,2%) dan leukemia limfositik kronik (2,2%). Karakteristik serologis tes Coombs pada AHAI tipe hangat adalah kombinasi anti-IgG + anti-C3 (84,8%) dan anti IgG (15,2%). Proporsi subjek AHAI tipe hangat yang memiliki positif dengan kortikosteroid adalah 71,7%. Etiologi AHAI tipe dingin adalah idiopatik atau primer (66,7%) dan mieloma multipel (33,3%). Tes Coombs menunjukkan anti-C3 dan ditemukannya cold antibody. Semua subjek AHAI tipe dingin berespon negatif setelah mendapatkan kortikosteroid. Didapatkan etiologi AHAI tipe campuran primer yang berespon positif setelah mendapatkan kortikosteroid dan tes Coombs menunjukkan anti-IgG + anti-C3 disertai antibody non-specific dengan titer yang tinggi. Simpulan. Mayoritas subjek AHAI adalah AHAI tipe hangat. Proporsi subjek AHAI tipe hangat yang berespon positif setelah mendapatkan kortikosteroid 71,7%, AHAI tipe campuran juga berespon positif, sedangkan semua subjek AHAI tipe dingin berespon negatif. Kata Kunci: AHAI tipe dingin, AHAI tipe hangat, AHAI tipe campuran, kortikosteroid, respon pengobatan  Auto Immune Hemolytic Anemia (AIHA) Patients Profile and Treatment Response to Corticosteroids in Cipto Mangunkusumo HospitalIntroduction. Autoimmune hemolytic anemia (AIHA) is one of the immunological diseases that causes hemolysis. Data on demographic characteristics and treatment response of AIHA patients has not available in Indonesia. This study was conducted to identify the profile of autoimmune hemolytic anemia (AIHA) patients and their response of treatment after receiving corticosteroid treatment.Methods. This cross-sectional study used data from the medical records of AIHA patients in the outpatient clinic division of the Hematology-Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Hospital between 2004-2008 which included: patient demography characteristics, AIHA classification and etiology, as well as the response of treatment to initial dose of corticosteroid, equivalent to prednisone 1-1,5 mg/kgbw/day for 3-4 weeks; with positive response marked by increase of Hb >10 g/dL. Results. From total of 50 subjects, the proportion of warm type, cold type and mix type were 92%, 6% and 2%, respectively. Most of the etiology of AIHA warm type was idiopathic or primary (54.3%), whereas the etiology of secondary type were systemic lupus erythematosus/LES (41.3%), autoimmune hepatitis (2.2%) and chronic lymphocytic leukemia (2.2%). Characteristics of serological Coombs tests on AIHA warm type were combination of anti-IgG + anti-C3 (84.8%) and the anti-IgG (15.2%). Meanwhile, the proportion of subjects with AIHA warm type that has a positive response to corticosteroids were 71.7%. This study found that the etiology of AIHA cold type were idiopathic or primary (66.7%) and multiple myeloma (33.3%). Coombs tests showed an anti-C3 and cold antibody and all subjects had negative response to corticosteroids. This study also found the etiology of AIHA mixed type was primary, had positive response to corticosteroids and Coombs test demonstrated anti-IgG + anti-C3 accompanied by a non-specific antibody with high titer. Conclusions. The majority of AIHA subjects are warm type AIHA, with a small portion being cold and mixed type. The proportion of warm type AIHA that respond positively to corticosteroids is 71,7%. All cold type AIHA subjects do not respond to corticosteroids while mixed type AIHA subjects show positive response. Keywords: cold type AIHA, mixed type AIHA, response to steroid treatment, warm type AIHA
Colonic Tuberculosis: a high Index of Suspicion Syam, Ari F; Chen, Khie; Rumende, C Martin; A, Djumhana; Abdullah, Murdani; SM, M Usman; Rajabto, Wulyo
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 2, August 2005
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/62200555-59

Abstract

Tuberculosis remains to be one of the most common problems in developing countries such as Indonesia. It can involve many organs including gastrointestinal tract. Colonic tuberculosis is an ancient disease and has long been recognized. However, it is sometimes difficult to make early diagnosis due to nonspecific sign and symptoms. In endemic areas, correct diagnoses were made only 50% of the time. Without a high index of suspicion of the disease, it has been rarely diagnosed correctly. We reported a case of colonic tuberculosis in 18 years old female patient with lung tuberculosis.Endoscopic examination showed ulcerative mucosa, ‘halo lesion’, and pseudopolyp while PPD skin test, sputum smear and histopathological examination of endoscopic biopsy revealed negative for tuberculosis infection. The presence of lung tuberculosis had made high index of suspicion of colonic tuberculosis. Standard regimen of antituberculosis therapy was given and the patient showed good clinical response.   Keywords: high index suspicion, colonic tuberculosis
The Pathogenic Triad of Chronic Cough: Postnasal Drip Syndrome, Asthma, and Gastroesophageal Reflux Disease Sundaru, Heru; Syam, Ari Fahrial; Rajabto, Wulyo
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 1, April 2007
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/81200720-23

Abstract

Chronic cough, lasting for 3 weeks or more, is one of the most common symptoms for which adult patients seek medical attention. The pathogenic triad of chronic cough is Postnasal Drip Syndrome (PNDS), Asthma, and Gastroesophageal Reflux Diseases (GERD) are the vast majority etiology of chronic cough in non-smoker adult with normal chest X-ray. The clinical investigations that should be performed are spirometry pre-post bronchodilator and bronchoprovocation testing for asthma; plain sinus radiograph and or computed tomographic imaging of the sinus for PNDS due to sinusitis; gastro-intestinal investigation 24 hours oesophageal pH monitoring and upper gastrointestinal endoscopy for GERD.   Keywords: chronic cough, postnasal drip syndrome, asthma, gastroesophageal reflux disease
Hubungan Gambaran Klinis dan Laboratorium Hematologis antara Leukemia Granulositik Kronik Ph (+)/BCR-ABL (+) dengan Bentuk Kelainan Ph/BCR-ABL Lainnya Wulyo Rajabto; A. Harryanto; Hilman Tadjoedin; Kuntjoro Harimurti
Jurnal Penyakit Dalam Indonesia Vol 5, No 1 (2018)
Publisher : Internal Medicine Department, Faculty of Medicine Universitas Indonesia-RSCM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (417.603 KB) | DOI: 10.7454/jpdi.v5i1.167

Abstract

Pendahuluan. Berdasarkan pengamatan, pasien Leukemia Granulositik Kronik (LGK) fase kronik di Poliklinik Hematologi-Onkologi Medik Departemen Ilmu Penyakit Dalam Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo (RSCM) Jakarta yang telah menjalani pemeriksaan sitogenetika dan/atau RT-PCR BCR-ABL, akan menunjukkan LGK Ph (+)/BCR-ABL (+) dan LGK bentuk kelainan Ph/ BCR-ABL lainnya. Penelitian ini dilakukan untuk mengetahui hubungan gambaran klinis dan laboratorium hematologis antara LGK Ph (+)/BCR-ABL (+) dengan LGK bentuk kelainan Ph/BCR-ABL lainnya.Metode. Studi potong lintang dilakukan pada pasien LGK yang dirawat di RSCM Jakarta. Sampel penelitian diambil dengan metode consecutive dan dianalisis menggunakan uji Chi-square dan regresi logistik dengan menggunakan SPSS 20 for windows. Hubungan antarvariabel dinyatakan bermakna apabila nilai p<0,05.Hasil. Dari total 80 subjek LGK fase kronik, didapatkan rerata usia yaitu 39,4 (simpang baku 13,1) tahun. Didapatkan perbandingan gambaran klinis dan laboratorium hematologis antara LGK Ph (+)/BCR-ABL (+) dan LGK bentuk kelainan Ph/BCR-ABL lainnya, yaitu: keluhan yang simtomatik 80,6%: 100%; splenomegali 82% : 92,3%; median Hb 10,3 g/dL : 10,3 g/dL; median leukosit 124.620 : 127.050, median trombosit 455.000 : 487.000. Namun demikian, hasil analisis bivariat dan multivariat menunjukkan tidak ada variabel gambaran klinis dan laboratorium hematologis yang berhubungan bermakna.Simpulan. Tidak ada variabel gambaran klinis dan laboratorium hematologis yang berhubungan bermakna antara LGK Ph(+)/BCR-ABL (+) dengan LGK bentuk kelainan Ph/BCR-ABL lainnya.Kata Kunci: Gambaran klinis, LGK, Laboratorium hematologisAssociation of Clinical Features and Hematological Laboratories between Ph (+)/BCR-ABL (+) Chronic Myeloid Leukemia and Other Type of Ph/BCR-ABL Chronic Myeloid LeukemiaIntroduction. Patients with chronic phase Chronic Myeloid Leukemia (CML) at Hematology-Medical Oncology Clinic Department of Internal Medicine dr. Cipto Mangunkusumo National Hospital who haveperformed cytogenetic and RTPCR BCR-ABL examination showed: Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML. This study aims to identify the clinical features and hematological laboratories of chronic phase CML, the proportion of Ph (+)/BCR-ABL (+) CML, and association of clinical features and hematological laboratories between Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML.Methods. This is a cross-sectional study. The samples were taken by consecutive method. We used Chi-square test and logistic regression analysis. Association between variables considered significant when p value <0.05.Results. There were 80 subjects with chronic phase CML. Mean of age was: 39.4 (standard deviation 13.1) years. The comparison of clinical features and hematological laboratories between Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML were: Symptomatic 80.6% : 100%; splenomegaly 82% : 92.3%; median of Hb 10,3 g/dL : 10,3 g/dL; median of white blood cell 124.620 : 127.050; median of thrombocyte 455.000 : 487.000. Bivariate and multivariate analysis showed no significant association of clinical features and hematological laboratories between Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML.Conclusion. There was no significant association of clinical features and hematological laboratories between Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML.
Profil Pasien Anemia Hemolitik Auto Imun (AHAI) dan Respon Pengobatan Pasca Terapi Kortikosteroid di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo Wulyo Rajabto; Djumhana Atmakusuma; Siti Setiati
Jurnal Penyakit Dalam Indonesia Vol 3, No 4 (2016)
Publisher : Internal Medicine Department, Faculty of Medicine Universitas Indonesia-RSCM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1342.487 KB) | DOI: 10.7454/jpdi.v3i4.54

Abstract

Pendahuluan. Anemia hemolitik auto imun (AHAI) merupakan salah satu penyakit imunologi yang menyebabkan hemolisis. Data mengenai karakteristik demografi dan respon pengobatan AHAI, khususnya pemberian kortikosteroid belum banyak didapatkan di Indonesia. Penelitian ini dilakukan untuk mengetahui profil pasien-pasien AHAI dan respon pengobatannya setelah mendapatkan kortikosteroid. Metode. Desain studi potong lintang dilakukan menggunakan status rekam medik pasien AHAI yang berobat jalan di Poliklinik Hematologi-Onkologi Medik Departemen Ilmu Penyakit Dalam RSUPN Dr. Cipto Mangunkusumo selama 5 tahun (2004- 2008). Variabel yang diteliti meliputi karakteristik demografi, klasifikasi AHAI dan etiologinya, serta respon pengobatannya setelah mendapatkan kortikosteroid dosis inisial setara prednison 1-1,5 mg/kgbb/hari selama 3-4 minggu, respon positif ditandai oleh meningkatkan kadar Hb ≥10 g/dL. Hasil. Dari total 50 subjek, didapatkan 92% AHAI tipe hangat, 6% tipe dingin dan 2% campuran. Etiologi AHAI tipe hangat adalah idiopatik atau primer (54,3%), sedangkan etiologi tipe sekunder adalah lupus eritematosus sistemik/LES (41,3%), hepatitis autoimun (2,2%) dan leukemia limfositik kronik (2,2%). Karakteristik serologis tes Coombs pada AHAI tipe hangat adalah kombinasi anti-IgG + anti-C3 (84,8%) dan anti IgG (15,2%). Proporsi subjek AHAI tipe hangat yang memiliki positif dengan kortikosteroid adalah 71,7%. Etiologi AHAI tipe dingin adalah idiopatik atau primer (66,7%) dan mieloma multipel (33,3%). Tes Coombs menunjukkan anti-C3 dan ditemukannya cold antibody. Semua subjek AHAI tipe dingin berespon negatif setelah mendapatkan kortikosteroid. Didapatkan etiologi AHAI tipe campuran primer yang berespon positif setelah mendapatkan kortikosteroid dan tes Coombs menunjukkan anti-IgG + anti-C3 disertai antibody non-specific dengan titer yang tinggi. Simpulan. Mayoritas subjek AHAI adalah AHAI tipe hangat. Proporsi subjek AHAI tipe hangat yang berespon positif setelah mendapatkan kortikosteroid 71,7%, AHAI tipe campuran juga berespon positif, sedangkan semua subjek AHAI tipe dingin berespon negatif. Kata Kunci: AHAI tipe dingin, AHAI tipe hangat, AHAI tipe campuran, kortikosteroid, respon pengobatan  Auto Immune Hemolytic Anemia (AIHA) Patients Profile and Treatment Response to Corticosteroids in Cipto Mangunkusumo HospitalIntroduction. Autoimmune hemolytic anemia (AIHA) is one of the immunological diseases that causes hemolysis. Data on demographic characteristics and treatment response of AIHA patients has not available in Indonesia. This study was conducted to identify the profile of autoimmune hemolytic anemia (AIHA) patients and their response of treatment after receiving corticosteroid treatment.Methods. This cross-sectional study used data from the medical records of AIHA patients in the outpatient clinic division of the Hematology-Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Hospital between 2004-2008 which included: patient demography characteristics, AIHA classification and etiology, as well as the response of treatment to initial dose of corticosteroid, equivalent to prednisone 1-1,5 mg/kgbw/day for 3-4 weeks; with positive response marked by increase of Hb >10 g/dL. Results. From total of 50 subjects, the proportion of warm type, cold type and mix type were 92%, 6% and 2%, respectively. Most of the etiology of AIHA warm type was idiopathic or primary (54.3%), whereas the etiology of secondary type were systemic lupus erythematosus/LES (41.3%), autoimmune hepatitis (2.2%) and chronic lymphocytic leukemia (2.2%). Characteristics of serological Coombs tests on AIHA warm type were combination of anti-IgG + anti-C3 (84.8%) and the anti-IgG (15.2%). Meanwhile, the proportion of subjects with AIHA warm type that has a positive response to corticosteroids were 71.7%. This study found that the etiology of AIHA cold type were idiopathic or primary (66.7%) and multiple myeloma (33.3%). Coombs tests showed an anti-C3 and cold antibody and all subjects had negative response to corticosteroids. This study also found the etiology of AIHA mixed type was primary, had positive response to corticosteroids and Coombs test demonstrated anti-IgG + anti-C3 accompanied by a non-specific antibody with high titer. Conclusions. The majority of AIHA subjects are warm type AIHA, with a small portion being cold and mixed type. The proportion of warm type AIHA that respond positively to corticosteroids is 71,7%. All cold type AIHA subjects do not respond to corticosteroids while mixed type AIHA subjects show positive response.
A Case of Primary Ileocecal Lymphoma Rajabto, Wulyo; Atmakusuma, Djumhana; S, Ivan Onggo; Makmun, Dadang
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 3 (2016): VOLUME 17, NUMBER 3, December 2016
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (605.972 KB) | DOI: 10.24871/1732016212-215

Abstract

Primary lymphoma in gastrointestinal tract is not very common. Ileocecal region is the commonest site for primary lymphoma and diffuse large B cell lymphoma (DLBCL) is the most prevalent subtype. The clinical presentation in this condition is pain in right lower quadrant region and this can very confusing since many diseases can also cause this problem like infection and inflammatory disease. In this paper, we report a case of primary lymphoma subtype DLBCL in ileocecal region that come to emergency department with ileus obstruction. Abdominal computerized tomography (CT) scan and colonoscopy revealed tumour in ileocecal region ascendens colon. Hemicolectomy was performed and the specimen was sent to pathology which revealed non-Hodgkin lymphoma with subtype DLBCL CD20 (+). The patient had undergone of Rituximab, Cyclophosphamide, Doxorubicine, Vincristin, and Prednison (RCHOP) chemotherapy regimen and had complete remission.
Ekspresi Topoisomerase II α pada Diffuse Large B Cell Lympho-ma dan Hubungannya dengan Respon Terapi Indri Windarti; Endang SR Hardjolukito; Maria Francisca Ham; Tubagus Djumhana Atmakusuma; Wulyo Rajabto
Majalah Patologi Indonesia Vol 22 No 3 (2013): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (515.276 KB)

Abstract

ABSTRAK Latar belakang Kemoterapi pilihan untuk Diffuse Large B Cell Lymphoma (DLBCL) adalah regimen yang mengandung doksorubisin. Doksorubisin merupakan obat kemoterapi golongan antrasiklin yang bekerja sebagai anti Topoisomerase II (Top2). Penelitian sebelumnya terhadap galur sel tumor menunjukkan bahwa ekspresi Topoisomerase II α (Top2A) yang tinggi berhubungan dengan sensitifitas terhadap antrasiklin yang tinggi pula. Tujuan penelitian ini adalah untuk mengetahui ekspresi protein Top2A pada DLBCL dan hubungannya dengan respon terapi. Metode Studi potong lintang dilakukan terhadap 38 kasus DLBCL dengan pulasan CD20 positif, yang telah mendapat kemoterapi minimal 4 siklus. Imunohistokimia dilakukan pulasan terhadap protein Top2A dengan menggunakan H-score. Hasil Ekspresi Top2A ditemukan pada 37 dari 38 kasus (97%) dengan kisaran H-score 101,5-215,0 dan median 124,1. H-score nilai Top2A dikatakan tinggi jika H-score lebih dari 124,1. Analisis statistik menunjukkan bahwa ekspresi Top2A pada DLBCL tidak berhubungan bermakna dengan respon terapi (p=0,670). Kesimpulan Ekspresi Top2A dan respon terapi tidak memiliki hubungan bermakna. Ekpresi Top2A pada DLBCL tidak dapat dijadikan prediktor respon terapi. Kata kunci: DLBCL, Doksorubisin, ekspresi Top2A, respon terapi. ABSTRACT Background Standard of chemotherapy for Diffuse Large B Cell Lymphoma (DLBCL) is a regimen containing doxorubicin. Doxorubicin is a component of anthracycline based chemotherapy that work as anti Topoisomerase II (Top2). Previous study on tumor cell lines showed that high expression of Topoisomerase II α (Top2A) was related to higher sensitivity to anthracycline as well. The aim of this study is to know the expression of Top2A and its relation to treatment response. Methods A cross-sectional study on 38 which DLBCL cases CD20 positive that have been treated with at least 4 cycles of chemotherapy. The immunohistochemical staining was performed on Top2A protein assesed using H-score. Results Expression of Top2A protein were found in 37 of 38 (97%) cases (H-score range: 101.5-215.0 and median 124.1). Value Top2A was defined as high if H-score more was higher than 124.1. Statistical analysis showed that Top2A expression in DLBCL was not significantly related to treatment response (p=0.670). Conclusion There was no significant relation between Top2A expression and treatment response. Top2A expression in DLBCL cannot be used as a predictor of treatment response. Key words: DLBCL, Doxorubicin, Top2A expression, treatment response.
After Imatinib Treatment Failure in Chronic Phase CML: What Can We Do? Wijayanto, Nicholas; Rajabto, Wulyo
Cermin Dunia Kedokteran Vol 45, No 10 (2018): Muskuloskeletal
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (241.392 KB) | DOI: 10.55175/cdk.v45i10.589

Abstract

Chronic myeloid leukemia(CML) is characterized by reciprocal translocation between chromosome 9 and 22. This translocation will activate the tyrosin kinase, leads to underlying pathogenesis of CML. Imatinib is the first line of Tyrosine Kinase Inhibitor (TKI) to treat chronic phase of CML, but resistance has been a significant problem. NCCN has announced recommendation to treat imatinib resistance, including high-dose imatinib, the use of nilotinib or dasatinib.Leukemia mielositik kronik(LMK) terjadi karena translokasi resiprokal antara kromosom 9 dan 22. Translokasi ini akan mengaktifkan enzim tyrosin kinase yang mencetuskan LMK. Imatinib adalah terapi lini pertama dari golongan Tyrosin Kinase Inhibitor (TKI) untuk LMK fase kronik. Namun, resistensi terhadap imatinib menjadi masalah yang cukup signifikan. NCCN telah mengeluarkan rekomendasi untuk menangani resistensi imatinib, yaitu pemberian imatinib dosis tinggi, nilotinib atau dasatinib.
Mutasi dan Varian Coronavirus Disease 2019 (COVID-19): Tinjauan Literatur Terkini Adityo Susilo; Chyntia Olivia Maurine Jasirwan; Syahidatul Wafa; Suzy Maria; Wulyo Rajabto; Akhmadu Muradi; Ihza Fachriza; Myranda Zahrah Putri; Stacy Gabriella
Jurnal Penyakit Dalam Indonesia Vol 9, No 1 (2022)
Publisher : Internal Medicine Department, Faculty of Medicine Universitas Indonesia-RSCM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.7454/jpdi.v9i1.648

Abstract

Pandemi Coronavirus disease 2019 (COVID-19) telah berlangsung sejak Maret 2020 hingga saat ini sudah hampir dua tahun melanda dunia, tak terkecuali Indonesia. Dalam perjalanannya sebagai patogen, SARS-CoV-2 sudah mengalami beberapa mutasi menjadi berbagai varian yang menjadi perhatian dunia. Varian-varian virus ini dikhawatirkan menghambat resolusi wabah, bahkan membuat wabah tidak terkendali. Masih banyak kontroversi dan riset yang berjalan tentang varian-varian baru SARS-CoV-2. Mekanisme penularan yang cepat dan belum meluasnya cakupan vaksinasi telah menyebabkan virus ini cepat bermutasi dan menimbulkan beberapa jenis varian baru. Hingga terakhir ini timbul varian baru Omicron (B.1.1.529) yang pertama ditemukan pada November 2021 di Afrika Selatan dan telah menyebar ke 103 negara. Daya transmisi Omicron yang lebih kuat dibandingkan varian sebelumnya membuat Omicron ditetapkan sebagai variant of concern (VoC). Meskipun beberapa informasi menyebutkan gejala yang ditimbulkan oleh varian ini cenderung ringan, akan tetapi kecepatan transmisi Omicron berpotensi menimbulkan peningkatan gelombang kasus COVID-19 berikutnya. Studi lebih lanjut diperlukan untuk mengetahui daya transmisi, patogenesis, diagnosis dan tata laksana yang tepat. Oleh karena itu, kami melakukan telaah terhadap studi-studi terkait berbagai mutasi dan varian COVID-19 hingga Januari 2022. Kata Kunci: COVID-19, mutasi, Omicron, pandemi, varianMutation and Variant of Coronavirus Disease 2019 (COVID-19): Review of Current LiteraturesSince March 2020, the Coronavirus Disease 2019 (COVID-19) pandemic has engulfed the world, including Indonesia, for nearly two years. SARS-CoV-2 has undergone several mutations during its evolution as a pathogen, resulting in various variants of global concern. Variants of this virus are suspected to impede the outbreak resolution and possibly causing the outbreak to spiral out of control. There is still considerable debate and research underway regarding the new SARS-CoV-2 variants. Rapid transmission mechanisms and widespread vaccination coverage have accelerated the virus’s mutation rate and resulted in numerous new variants. To date, this has resulted in the discovery of a new variant Omicron (B.1.1.529) in November 2021 in South Africa, which has since spread to 103 countries. Omicron is designated a Variant of Concern (VoC) due to its more powerful transmission than the previous variant. Although some information indicates that the symptoms associated with this variant are typically mild, the rapid transmission of Omicron can increase the next wave of COVID-19 cases. Additional research is required to determine transmissibility, pathogenesis, diagnosis, and proper management. As a result, we conducted an adjunct to studies on various COVID-19 mutations and variants until January 2022.