Djumhana Atmakusuma, Djumhana
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Efficacy and Safety of In-Asia-Manufactured rhG-CSF 300 mcg As Primary Prophylaxis for Prevention of CHOP Chemotherapy-induced Severe Neutropenia in Elderly Patients with Lymphoma Non-Hodgkin Reksodiputro, Harryanto; Djoerban, Zubairi; Tambunan, Karmel L.; Sudoyo, Aru W.; Widjanarko, Abidin; Atmakusuma, Djumhana; Syafei, Syafrizal; Prayogo, Nugroho; Hukom, Ronald; Ranuhardy, Dody; Jack, Zakifman; Harsal, Asrul; -, Noorwati S; Karsono, Bambang; Effendi, Shufrie; Tadjoedin, Hilman
Indonesian Journal of Cancer Vol 3, No 1 (2009): Jan - Mar 2009
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

Penelitian open-label, non-komparatif ini dilakukan untuk mengevaluasi efektivitas dan keamanan recombinant human G-CSF produksi Asia sebagai profilaksis primer dalam pencegahan neutropenia derajat berat pada pasien usia lanjut (>60 tahun) dengan limfoma non-Hodgkin (LNH) derajat sedang dan lanjut (stadium II,III,IV) yang mendapat terapi CHOP (siklofosfamid, doksorubisin, vinkristin). Profilaksis primer recombinant human G-CSF (rhG-CSF) produksi Asia dapat mengurangi median durasi neutropenia derajat 4 pada siklus sitostatistika ke-1 dan ke-2 menjadi tiga hari, sementara median durasi neutropenia derajat 3 pada siklus sitostistika ke-1 menjadi dua hari dan pada siklus sitostatistika ke-2 menjadi dua setengah hari, dari median durasi neutropenia grade 4 dan grade 3 tanpa G-CSF, yaitu empat dan lima hari berurutan. Febrile neutropenia ditemukan pada 7 pasien yang mendapat rhG-CSF produksi Asia (24.1%), lebih rendah jika dibandingkan studi tanpa rhG-CFS (31.3-34% FN). Tiga pasien mendapat rhG-CSF produksi Asia (10,3%) dirawat inap akibat febrile neutropenia, lebih rendah jika dibandingkan rawat inap pada studi tanpa rhG-CSF (24-28%). Kejadian yang tidak diinginkan terbanyak adalah mual dan muntah yang terjadi pada 9 (31%) pasien. Sebagai kesimpulan, penggunaan rhG-CSF produksi Asia untuk profilaksis primer pada pasien LNH usia lanjut yang mendapat regimen CHOP dapat mengurangi durasi neutropenia, mengurangi kejadian febrile neutropenia, dan angka rawat inap akibat febrile neutropenia.Kata kunci : Efektivitas, keamanan, G-CSF, LNH pada usia lanjut
Guidelines in Chemotherapy Atmakusuma, Djumhana; Hospital, Dharmais Cancer
Indonesian Journal of Cancer Vol 2, No 5 (2008): Workshop 2008
Publisher : "Dharmais" Cancer Center Hospital

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Guidelines in Chemotherapy full text: http://www.scribd.com/doc/45151303/Guidelines-in-Chemotherapy
Evaluation of Kidney Injury Molecule-1 (KIM-1) and Neutrophil Gelatinase-Associated Lipocalin (NGAL) Urinary Levels for Detecting Kidney Dysfunction in Patients With Nasopharyngeal Cancer Treated With Cisplatin-Based Treatment Rejeki, Marliana Sri; Arozal, Wawaimuli; Setiabudy, Rianto; Atmakusuma, Djumhana
Indonesian Journal of Cancer Vol 12, No 2 (2018): April-June
Publisher : National Cancer Center - Dharmais Cancer Hospital

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Abstract

Background: Cisplatin has a potency of causing nephrotoxicity. Serum BUN and creatinine levels have been well-known for detecting kidney dysfunction; while KIM-1 and NGAL urine levels are relatively new measurements. The study was aimed to evaluate urinary KIM-1 and NGAL level to detect kidney dysfunction in patients with advanced stage NPC who received cisplatin-based chemotherapy.Methods: The study was a cohort-prospective study with 3 subject groups, i.e. patients who had never received and who had received 75-100 mg/m2 cisplatin-based chemotherapy as well as those who had never received 40 mg/m2 cisplatin-based chemotherapy. The levels of urinary KIM-1, NGAL and serum level of BUN and creatinine were measured before and after receiving cisplatin. Statistical analyses were ANOVA, Pearson, Spearman, Kolmogorov-Smirnov test and SPSS version 22.0.Result: There was a significant difference of delta BUN level (p=0.0001) and delta urinary NGAL level (p = 0.025) before and after treatment in all three groups; while delta KIM-1 level showed no significant difference in all three groups (p=0.275). Cisplatin may cause accumulated nephrotoxicity, which has dose-dependent manner.Conclusion: Measuring urinary NGAL level can detect an early stage of kidney dysfunction; however, it still cannot replace the role of BUN. Measurement of urinary KIM-1 level cannot detect kidney dysfunction.
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.
Perubahan Kadar Fibrinogen Plasma dan Korelasinya dengan Perubahan Kadar hs-CRP dan Aktivitas Fibrinolisis pada Sindroma Koroner Akut Sudrajat, Dedy G.; Atmakusuma, Djumhana; Alwi, Idrus; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Pendahuluan: Peningkatan kadar fibrinogen yang menetap merupakan faktor risiko yang kuat untuk kejadian penyakit jantung koroner (PJK). Di sisi lain peningkatan fibrinogen plasma dapat merupakan respon fase akut. Pada kondisi ini peningkatan fibrinogen plasma bukan merupakan faktor risiko PJK. Penelitian ini bertujuan untuk mengetahui apakah kadar fibrinogen plasma meningkat pada fase akut dan tetap tinggi pada fase pasca akut dan mengetahui korelasi antara perubahan kadar fibrinogen plasma dengan perubahan aktivitas inflamasi dan fibrinolisis. Metode: Desain penelitian adalah studi prospektif dengan metode pengambilan sampel secara konsekutif. Pengambilan sampel fase akut untuk hs-CRP, aktivitas fibrinolisis, dan fibrinogen masing-masing diambil pada hari ke-2, 5, dan 6 pasca awitan sedangkan fase pasca akut diambil pada hari ke-13 pasca awitan. Fibrinogen diperiksa dengan metode Clauss, hs-CRP dengan metode ELISA, dan aktivitas fibrinolisis dengan metode ECLT manual. Analisis beda rerata dilakukan dengan uji t-berpasangan dengan alternatif uji wilcoxon. Analisis korelasi dengan uji Spearman. Hasil: Sampai akhir penelitian didapatkan 38 subyek sesuai kriteria inklusi dan eksklusi. Terdapat penurunan median kadar fibrinogen plasma pada fase pasca akut dibandingkan fase akut (415,5vs380,5mg/dL;p Simpulan: Pada sindroma koroner akut, perubahan aktivitas fibrinolisis dan inflamasi memiliki korelasi positif lemah terhadap perubahan kadar fibrinogen. Pada kelompok dengan hiperfibrinogenemia yang menetap kadar fibrinogen pasca akut masih dominan dipengaruhi aktivitas inflamasi yang masih cukup aktif.
Auto Immune Hemolytic Anemia (AIHA) Patients Profile and Treatment Response to Corticosteroids in Cipto Mangunkusumo Hospital Rajabto, Wulyo; Atmakusuma, Djumhana; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 4
Publisher : UI Scholars Hub

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