scholarly journals Correlative Study Between Nutritional Status and Remission Outcome in Childhood Acute Lymphoblastic Leukemia in Dr. Soetomo General Hospital Surabaya

2019 ◽  
Vol 2 (1) ◽  
pp. 27
Author(s):  
Asma' Athifah ◽  
Siti Nurul Hidayati ◽  
Sulistiawati Sulistiawati
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Nutritional Status ◽  
General Hospital ◽  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
High Risk Group ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Induction Phase ◽  
Cross Sectional ◽  
Term Survival

Introduction: The most common malignancy that is diagnosed in children is acute lymphoblastic leukemia. Undernourished children tend to have poorer long term survival. This descriptive analytic study is aimed towards analyzing the correlation between nutritional status at diagnosis and outcomes of induction phase therapy in childhood acute lymphoblastic leukemia at the Department of Pediatrics Dr. Soetomo General Hospital Surabaya in 2014.Methods: A cross-sectional method using the medical records of patients is used in this study. The nutritional statuses of patients are calculated using weight for length/height trough curves of WHO 2006 or CDC 2000.Results: The results show that from 45 children diagnosed with ALL, 53% are of the age ≤ 5 years old, with 58% males and 42% females. 13% of the patients are in the high risk group and 87% are in the standard risk group. Nutritional statuses of patients are 2% of them obese experienced remission after induction phase therapy, 56% normal with 80% of them experienced remission. 40% underweight with 89% of them experienced remission and 11% not experienced remission, 2% malnutrition and experienced remission. There is no correlation between the nutritional status of children with acute lymphoblastic leukemia with the outcome of induction phase (p = 0.798).Conclusion: In conclusion, there is no correlation between nutritional status and remission outcome of patients with ALL in the induction phase of therapy. However, high percentage of underweight patients shows nutrition needs special attention to improve therapy outcomes.

scholarly journals ANALYSIS OF INDUCTION PHASE GLUCOCORTICOID USE ON ADRENAL SUPPRESSION IN PEDIATRIC PATIENTS WITH ACUTE LYMPHOBLASTIC LEUKEMIA

2017 ◽  
Vol 52 (1) ◽  
pp. 7
Author(s):  
Octaviana Simbolon ◽  
Yulistiani Yulistiani ◽  
I DG Ugrasena ◽  
Mariyatul Qibtiyah
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
High Risk ◽  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
High Risk Group ◽  
Adrenal Suppression ◽  
Induction Phase ◽  
Childhood All ◽  
Cortisol Levels ◽  
Standard Risk

Glucocorticoids play an important role in the treatment of acute lymphoblastic leukemia (ALL). However, supraphysiological doses may cause suppression of the adrenal. Adrenal suppression resulting in reduced cortisol response may cause an inadequate host defence against infections, which remains a cause of morbidity and mortality in children with ALL. The occurrence of adrenal suppression before and after glucocorticoid therapy for childhood ALL is unclear. The aim of this study is to analysis the effect of glucocorticoid on cortisol levels during induction phase chemotherapy in children with acute lymphoblastic leukemia. A cross-sectional, observational prospective study was conducted to determine the effect of glucocorticoid on cortisol levels in children with acute lymphoblastic leukemia. Patients who met inclusion criteria were given dexamethasone or prednisone therapy for 49 days according to the 2013 Indonesian Chemotherapy ALL Protocol. Cortisol levels were measured on days 0, 14, 28, 42 and 56 of induction phase chemotherapy. There were 24 children, among 31 children recruited, who suffered from acute lymphoblastic leukemia. Before treatment, the means of cortisol levels were 228.95 ng/ml in standard risk group (prednisone) and 199.67 ng/ml in high risk group (dexamethasone). In standard risk group, the adrenal suppression occurs at about day 56. There was a significant decrement of cortisol levels in high risk group in days 14, 28, 42 against days 0 of induction phase (p=0.001). Both groups displayed different peak cortisol levels after 6 week of induction phase (p=0.028). Dexamethasone resulted in lower cortisol levels than prednisone during induction phase chemotherapy in children with acute lymphoblastic leukemia.

scholarly journals Blood glucose level during induction phase chemotherapy in childhood acute lymphoblastic leukemia

2020 ◽  
Vol 60 (4) ◽  
pp. 197-2
Author(s):  
Nunki Andria ◽  
Annang Giri Moelyo ◽  
Muhammad Reza
Keyword(s):  
Blood Glucose ◽  
Acute Lymphoblastic Leukemia ◽  
Nutritional Status ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Side Effect ◽  
Lymphoblastic Leukemia ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Induction Phase ◽  
Remission Status

Background Steroids and L-asparaginase (L-Asp) are agents used in induction phase chemotherapy for childhood acute lymphoblastic leukemia (ALL). Both agents are often reported to have the side effect of hyperglycemia, and native L-Asp is also reported to cause hypoglycemia. In ALL patients, hyperglycemic events during chemotherapy can cause lower 5-year overall and relapse-free survival. Objective To investigate the incidence of abnormal blood glucose level (BG) as the side effect of prednisone and L-Asp during induction phase chemotherapy, its  predisposing factors, and its effect on remission status. Methods This cohort prospective study was conducted in 36 children aged 1-18 years who were newly diagnosed with childhood ALL at Dr. Moewardi Hospital, Surakarta, Central Java. Subjects’ nutritional status consist of wellnourished and undernourishment. Subjects underwent BG monitoring. At the end of induction phase chemotherapy, subjects underwent bone marrow puncture (BMP) evaluation to assess their response to chemotherapy and the effect of abnormal BG on remission status. Results Hypoglycemia, a combination of hypoglycemia and hyperglycemia, hyperglycemia, as well as euglycemia, were experienced by 9, 7, 6, and 14 subjects, respectively. Nutritional status was found to be a significant risk factor for abnormal BG. There was no significant difference in remission status at the end of induction phase chemotherapy between the euglycemic group and abnormal BG groups (P=0.533). Conclusion Abnormal BG during induction phase chemotherapy did not affect remission status at the end of induction phase.  Undernourishment is also found to be a predisposing factor in abnormal BG.

scholarly journals Karakteristik dan Jumlah Leukosit pada Anak Penderita Leukemia Limfoblastik Akut yang Menjalani Kemoterapi Fase Induksi di Rumah Sakit Al Islam Bandung

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Fairuz Fakhri Luthfiyan ◽  
Lia Marlia Kurniawati ◽  
Ieva Baniasih Akbar
Keyword(s):  
Bone Marrow ◽  
Acute Lymphoblastic Leukemia ◽  
Nutritional Status ◽  
Lymphoblastic Leukemia ◽  
Genetic Disorders ◽  
Current Therapy ◽  
Induction Phase ◽  
Cross Sectional ◽  
Leukocyte Counts ◽  
Cross Sectional Design

Leukemia limfoblastik akut (LLA) adalah kelompok keganasan heterogen dengan sejumlah kelainan genetik khas yang menghasilkan berbagai perilaku klinis dan respons terhadap terapi. Pasien LLA pada umumnya identik dengan jumlah leukosit yang tinggi,  terapi saat ini adalah dengan cara kemoterapi yang terdiri atas 3 fase, yaitu induksi, konsolidasi, dan pemeliharaan. Keberhasilan kemoterapi ditentukan banyak faktor antara lain adalah terjadi remisi setelah kemoterapi fase induksi. Penelitian ini bertujuan mengetahui karakteristik dan jumlah leukosit pada anak penderita LLA setelah fase induksi kemoterapi. Metode yang digunakan adalah deskriptif dengan rancangan potong lintang  yang menggunakan data rekam medik pasien LLA  periode tahun 2019 usia 0 - 15 tahun. Penelitian ini dilaksanakan selama bulan Oktober 2020, teknik pengambilan data menggunakan total sampling. Pada penelitian ini didapatkan 137 data rekam medik, data yang memenuhi kriteria inklusi sebanyak 74 data. Kasus LLA paling banyak terjadi pada usia 0 - 5 tahun pada 41 pasien (55%), jenis kelamin laki-laki 43 pasien (58%), status gizi baik 46 pasien (62%), morfologi sumsum tulang remisi 63 pasien (85%), dan jumlah leukosit 4500-13500/mm3 pada 52 pasien (70%), remisi sumsum tulang terbanyak pada jumlah leukosit 4 pada 45 pasien (61%). Simpulan,  karakteristik pasien LLA terba500-13500/mm3nyak laki-laki, usia 0 - 5 tahun status gizi baik dan morfologi sumsum tulang remisi.  Characteristics and Number of Leukocytes in Children with Acute Lymphoblastic Leukemia who Underwent Induction Phase Chemotherapy at Al Islam Hospital BandungAcute lymphoblastic leukemia (ALL) is a heterogeneous group of malignancies with a number of characteristic genetic disorders that produce a variety of clinical behaviors and responses to therapy. LLA patients are generally synonymous with high leukocyte counts. Current therapy is chemotherapy which consists of 3 phases, namely induction, consolidation, and maintenance. The success of chemotherapy is determined by many factors, including remission after induction phase chemotherapy. This study aims to determine the characteristics and number of leukocytes in children with LLA after the chemotherapy induction phase. The method used was descriptive with a cross-sectional design using medical records of LLA patients periode 2019 aged 0-15 years. study was held in October 2020. In this study, there were 137 medical record data, data that met the inclusion criteria were 74 data. LLA cases in this study mostly occurred at the age of 0 - 5 years, amounting to 41 patients (55%), male gender totaled 43 patients (58%), good nutritional status totaled 46 patients (62%). ), the morphology of bone marrow remission totaled 63 patients (85%), and for the number of leukocytes 4500 - 13500/mm3 as many as 52 patients (70%), the greatest occurrence of bone marrow remission was in the number of leukocytes 4500/mm3-13500/mm3 as many as 45 patients (61%). In conclusion, characteristics of most ALL patients are male, age of 0 - 5 years with good nutritional status and bone marrow morphology showing remission. Characteristics and Number of Leukocytes in Children with Acute Lymphoblastic Leukemia who Underwent Induction Phase Chemotherapy at Al Islam Hospital Bandung

Evaluation of VEGF-A in relation to childhood acute lymphoblastic leukemia (in Basrah/Iraq)

2021 ◽  
Vol 3 (1) ◽  
pp. 39-44
Author(s):  
Zainab Badr ◽  
Wijdan AL-Moosawi ◽  
Sadiq Ali
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Acute Lymphoblastic Leukemia ◽  
Growth Factor ◽  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
High Risk Group ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Healthy Children ◽  
Vascular Endothelial ◽  
Endothelial Growth Factor

Background: Cancer angiogenesis demonstrates an important role in the progression and pathogenesis of blood malignant disorders including acute lymphoblastic leukemia (ALL). Vascular endothelial growth factor (VEGF)-A is one of the most effective elements of endothelial cell growth; it promotes vascular permeability of endothelial cells and provides the new vasculature with oxygen and nutrients. Higher VEGF-A levels in childhood acute lymphoblastic leukemia (ALL) is associated with poorer patient outcomes. Aim of the study: to assess the level of VEGF-A in plasma of children with ALL. Subject and method: Forty children with ALL and 40 healthy children as control were enrolled in this study conducted at the Oncology Unit in Basrah Children’s Hospital from Oct 2019 to March 2020. Plasma VEGF-A level was evaluated using ELISA assay. Results: The plasma level of VEGF-A is higher in ALL children than those in the control (p < 0.001). Moreover, the plasma VEGF-A level in the high-risk group (HRG) is higher than that in the standard risk group (SRG). Conclusion: The significantly higher level of plasma VEGF-A in ALL children compared to the healthy ones may demonstrate the role of VEGF-A in stimulating angiogenesis in pediatric ALL. Keywords: Angiogenesis, vascular endothelial growth factor-A, childhood acute lymphoblastic leukemia, acute lymphoblastic risk groups.

Treatment results in childhood acute lymphoblastic leukemia with a modified ALL-BFM’90 protocol: lack of improvement in high-risk group

1999 ◽  
Vol 23 (4) ◽  
pp. 331-340 ◽  
Author(s):  
Federico Sackmann-Muriel ◽  
Marı́a Sara Felice ◽  
Pedro Alberto Zubizarreta ◽  
Elizabeth Alfaro ◽  
Marta Gallego ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
High Risk ◽  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
High Risk Group ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Treatment Results

Impact of anti‐oxidant status and apoptosis on the induction phase of chemotherapy in childhood acute lymphoblastic leukemia

Hematology ◽  
2011 ◽  
Vol 16 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Youssef Al‐Tonbary ◽  
Samir Abou Al‐Hasan ◽  
Maysaa Zaki ◽  
Ayman Hammad ◽  
Shaimaa Kandil ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Induction Phase ◽  
Anti Oxidant ◽  
Oxidant Status

scholarly journals 3-year survival rate in acute lymphoblastic leukemia: comparison of ALL-2006 and ALL-2013 Protocols

2021 ◽  
Vol 61 (3) ◽  
pp. 155-64
Author(s):  
Avyandita Meirizkia ◽  
Dewi Rosariah Ayu ◽  
Raden Muhammad Indra ◽  
Dian Puspita Sari
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Survival Rate ◽  
High Risk ◽  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
Survival Rates ◽  
High Risk Group ◽  
Age At Diagnosis ◽  
Protocol Group ◽  
Remission Rates

Background With advances in supportive and risk-stratified therapy, the 5-year survival rate of acute lymphoblastic leukemia has reached 85.5%. The ALL-2006 treatment protocol was modified and renamed the ALL-2013 protocol, with dose and duration changes. Objective To compare outcomes of the ALL-2006 and ALL-2013 protocols, with regards to mortality, remission, relapse, and three-year survival rates. Methods This was retrospective cohort study. Subjects were acute lymphoblastic leukemia (ALL) patients treated from 2011 to 2018 in Mohamad Hoesin Hospital, Palembang, South Sumatera. The three-year survival rates, relapse, remission rates and comparison of ALL-2006 and ALL-2013 protocols were analyzed with Kaplan-Meier method. Results Mortality was significantly correlated with age at diagnosis <1 year and >10 years, hyperleukocytosis, and high-risk disease status. Patients aged 1 to 10 years, with leukocyte count <50,000/mm3 and standard-risk status had significantly higher likelihood of achieving remission. Mortality was not significantly different between the ALL-2006 protocol group [70.6%; mean survival 1,182.15 (SD 176.89) days] and the ALL-2013 protocol group [72.1%; mean survival 764.23 (SD 63.49) days]; (P=0.209). Remission was achieved in 39.2% of the ALL-2006 group and 33% of the ALL-2013 group (P>0.05). Relapse was also not significantly different between the two groups (ALL-2006: 29.4% vs. ALL-2013: 17.9%; P>0.05). Probability of death in the ALL-2006 group was 0.3 times lower than in the ALL-2013 group (P<0.05), while that of the high-risk group was 3 times higher. Remission was 2.19 times higher in those with leukocyte <50,000/mm3 compared to those with hyperleukocytosis. In addition, relapse was significantly more likely in high-risk patients (HR 2.96; 95%CI 1.22 to 7.19). Overall, the 3-year survival rate was 33%, with 41.7% in the ALL-2006 group and 30.7% in the ALL-2013 group. Conclusion Three-year survival rate of ALL-2006 protocol is higher than that of ALL-2013 protocol but is not statistically significant.  Age at diagnosis <1 year and >10 years, hyperleukocytosis, and high-risk group are significantly correlated with higher mortality and lower remission rates. However, these three factors are not significantly different in terms of relapse.   

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