Aim: To assess CML patient's characteristic including demographic, clinical and hematological characteristic of patients with CML including quantitative BCR-ABL and BCR-ABL gene sequencing. Methods: This study was an open-label, single arm, non-randomized, cross sectional study in patients with CML being treated with imatinib mesylate (IM) from 12 centers. Result: A total of 100 patients were evaluated between January 1, 2009 and December 31, 2011. The median age was 34-35 years old (mean of age is 36 years old), and more patients in the productive age was found.-(?) were 80 of the 100 patients who had been examined for the BCR-ABL gene mutation with the sequencing method before consuming IM. Mutation in the P-loop was seen in 2,27% (1 out of 44 patients), this finding was beyond our expectation since 47,69% (31 out of 65 patients) of our patients did not achieved CHR at three months. On the other hand, 15,9% (7 out of 44 patients) of our patients had mutation outside the P-loop. Conclusions: The characteristics of CML patients in Indonesia were not different from CML patients in Asia in general. Our finding concerning the high frequency mutation in the BCR-ABL gene outside the P-loop needs further study.
Introduction: Rhabdomyosarcoma (RMS) is the most common childhood soft tissue sarcoma, but it represents only a small portion of soft tissue sarcoma in adult population. There is a treatment protocol based on Intergroup Rhabdomyosarcoma Study (IRS) that provides satisfactory results in treating RMS in children, but there is only limited evidence regarding the outcome and prognosis in extrapolating the IRS protocol to treat RMS in adults. We report a case of adult pleomorphic RMS treated with multidisciplinary approach and the results we have obtained. Case presentation: A 48-year-old woman was admitted in February 2011 due to a painful mass on her left thigh. Diagnosis of pleomorphic rhabdomyosarcoma was made by histopathology and immunohistochemistry. After multimodal treatment that includes Trans-Arterial Chemotherapy Infusion, Cryosurgery, and wide excision surgery, our patient remains disease-free as of the latest annual follow up examination on June 2017. Conclusions: The pleomorphic type of Rhabdomyosarcoma is very rare in adults and is often associated with a poor prognosis. In our case, a multidisciplinary approach with multimodal treatment provides excellent result, even after a routine follow up spanning through six years.
Background The association between prior exposure to immune checkpoint inhibitor (ICI) and outcomes of cancer patients with coronavirus disease 2019 (COVID-19) infection has yet to be systematically evaluated. As the current evidence remains equivocal, this meta-analysis aims to investigate the effects of ICI treatment on COVID-19 prognosis, including mortality, severity, and hospitalization.Methods Eligible studies published up to 14 September 2020 were included and assessed for risk of bias using the Quality in Prognosis Studies tool. A random-effects meta-analysis was conducted to estimate the pooled effect size along with 95% confidence intervals (CIs). The quality of body evidence was evaluated using the modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.Results Six studies involving a total of 1647 COVID-19-infected cancer patients were included in the systematic review. We discovered that prior ICI exposure was not associated with COVID-19 mortality (odds ratio [OR] 0.93 [95% CI: 0.37-2.36]; I2=30%), severity (OR 1.15 [95% CI: 0.40-3.28]; I2=0%), and hospitalization (OR 1.35 [95% CI: 0.64-2.87]; I2=51%). However, we discovered that prior exposure to chemoimmunotherapy predicted COVID-19 severity (OR 8.19 [95% CI: 2.67-25.08]; I2=0%), albeit with small sample size. GRADE assessments resulted in moderate-quality evidence for mortality, while the other outcomes yielded very low-to-low-quality evidenceConclusion Our findings indicated that ICI treatment should not be adjourned nor terminated during the current pandemic. Rather, COVID-19 vigilance should be increased, especially in patients receiving chemoimmunotherapy. Further studies with larger ICI cohorts are required to confirm our findingsTrial registration number: This project has been prospectively registered at PROSPERO (registration ID: CRD42020202142) on 4 August 2020.
Pendahuluan. Komplikasi kardiovaskular yang disebabkan oleh disfungsi endotel menjadi salah satu penyebab mortalitas yang cukup tinggi pada pasien Artritis Reumatoid (AR). Faktor Reumatoid (RF) merupakan autoantibodi yang sering dijumpai pada AR dan diduga dapat meningkatkan respon inflamasi dan disfungsi endotel. Sindroma metabolik dapat pula meningkatkan disfungsi endotel. Belum ada studi yang menilai korelasi RF dan disfungsi endotel pada pasien AR tanpa sindroma metabolik. Penelitian ini bertujuan untuk mengetahui korelasi antara kadar RF dengan kadar VCAM-1 pada pasien AR tanpa sindroma metabolik. Metode. Penelitian desain potong lintang terhadap pasien AR dewasa yang berobat di Poliklinik Reumatologi RSUPN Cipto Mangunkusumo tanpa sindroma metabolik. Pengumpulan data dilakukan sejak Februari hingga Maret 2018 dari data penelitian sebelumnya yang diambil periode Februari 2016 hingga September 2017. Kadar RF dan VCAM-1 dinilai melalui pemeriksaan serum darah dengan metode ELISA. Korelasi antarkedua variabel dibuat dengan analisis korelasi Spearman menggunakan SPSS versi 20.0. Hasil. Sebanyak 46 subjek diikutsertakan dalam penelitian ini. Sebagian besar (95,7%) subjek adalah perempuan dengan rerata usia 44,43 tahun, median lama sakit 36 bulan, dan sebagian besar memiliki derajat aktivitas sedang (52,2%). sebagian besar pasien memiliki RF positif (63%). Korelasi antara kadar RF dengan kadar VCAM-1 memiliki kekuatan korelasi yang lemah tetapi tidak bermakna secara statistik (r=0,264; p=0,076). Subjek dengan RF positif memiliki kadar VCAM-1 yang lebih tinggi (626,89 vs. 540,96 ng/mL). Simpulan. Belum didapatkan korelasi antara RF dengan VCAM-1 pada pasien Artritis Reumatoid tanpa sindroma metabolik.
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