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All Journal Indonesian Journal of Cancer Jurnal Penyakit Dalam Indonesia
Shufrie Effendi, Shufrie
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Health Professions Medicine & Pharmacology

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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
The Changes of Amino Terminal Pro B-type Natriuretic Peptide(NT-proBNP) Concentration and Left Ventricular EjectionFraction on Doxorubicin Chemotherapy Patients Kamelia, Telly; Waspadji, Sarwono; Makmun, Lukman Hakim; Effendi, Shufrie; Ramli, Muchlis; Timan, Ina Susanti
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 2
Publisher : UI Scholars Hub

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Introduction. Cancer patients who received chemotherapy regimen containing doxorubicin has been known to have serious side effect in heart, called as cardiotoxicity. The measurement of NT-proBNP proposed to be used as a new parameter to identify and evaluate cardiotoxicity in cancer patients earlier before it has been manifested, superior than measurement of left ventricle ejection fraction (LVEF). The aims of this study to examine the changes of NT-proBNP concentration and LVEF on patients with cancer who receive chemotherapy regimen containing doxorubicin. Methods. The study used pre and post test design to observe the changes of NT-proBNP concentration and LVEF on the patients who receive naïve doxorubicin chemotherapy and after chemotherapy-cycle I to cyce IV at the Ciptomangunkusumo hospital, Jakarta. Echocardiography and NT-proBNP were examined on naïve chemotherapy and after chemotherapy each cycle. Statistical analysis was performed by using two way Anova and Friedman nonparametric test. Results. During the period of October 2007 to June 2008, a total of 29 consecutive patiets receiving doxorubicin chemotherapy regimen CHOP (Cyclophosphamide, doxorubicin, Vincristine, Prednisone and FAC-5 Fluorouracil, doxorubicin, Cyclophosphamide) were collected. The increase of median NT-proBNP concentration between naïve chemotherapy and: post chemotherapy cycle I was 32 pg/mL (12,5-124,6 pg/mL), post chemotherapy cycle II was 135 pg/mL (44-275,2 pg/mL), post chemotherapy cycle III was 275,1 pg/mL (97,8-907,2 pg/mL), post chemotherapy cycle IV was 514,6 pg/mL (80,6-6458,2 pg/mL). With Friedman test, p< 0,000. With Anova two way test, it was found the difference between naïve LVEF and LVEF: post chemotherapy cycle I was 5,1% (p 0,000), post chemotherapy cycle II 8,9% (p 0,000), post chemotherapy cycle III 11,2% (p 0,000), post chemotherapy cycle IV 12,5% (p 0,000). Conclusions. Elevated NT-proBNP concentration and LVEF reduction had been observed in doxorubicin chemotherapy patients.
Co-Authors Abidin Widjanarko Andhika Rachman Arini Setiawati Aru W. Sudoyo Asrul Harsal, Asrul Bambang Karsono Djumhana Atmakusuma, Djumhana Dody Ranuhardy, Dody Harryanto Reksodiputro, Harryanto HILMAN TADJOEDIN, HILMAN Ikhwan Rinaldi Ina Susanti Timan, Ina Susanti Karmel L Tambunan, Karmel L Karmel L. Tambunan Lugyanti Sukrisman Lukman Hakim Makmun Muchlis Ramli Noorwati S -, Noorwati S Nugroho Prayogo Ronald Hukom Sarwono Waspadji Syafrizal Syafei, Syafrizal T. Djumhana Atmakusuma, T. Djumhana Telly Kamelia Zakifman Jack, Zakifman Zubairi Djoerban