scholarly journals Identification of a Seven-lncRNA-mRNA Signature for Recurrence and Prognostic Prediction in Relapsed Acute Lymphoblastic Leukemia Based on WGCNA and LASSO Analyses

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Haiyan Qi ◽  
Long Chi ◽  
Xiaogang Wang ◽  
Xing Jin ◽  
Wensong Wang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Lymphoblastic Leukemia ◽  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
Characteristic Curve ◽  
High Risk Group ◽  
Curve Analysis ◽  
Clinical Relapse ◽  
Messenger Rnas ◽  
Childhood All

Abnormal expressions of long noncoding RNAs (lncRNAs) and protein-encoding messenger RNAs (mRNAs) are important for the development of childhood acute lymphoblastic leukemia (ALL). This study developed an lncRNA-mRNA integrated classifier for the prediction of recurrence and prognosis in relapsed childhood ALL by using several transcriptome data. Weighted gene coexpression network analysis revealed that green, turquoise, yellow, and brown modules were preserved across the TARGET, GSE60926, GSE28460, and GSE17703 datasets, and they were associated with clinical relapse and death status. A total of 184 genes in these four modules were differentially expressed between recurrence and nonrecurrence samples. Least absolute shrinkage and selection operator analysis showed that seven genes constructed a prognostic signature (including one lncRNA: LINC00652 and six mRNAs: INSL3, NIPAL2, REN, RIMS2, RPRM, and SNAP91). Kaplan-Meier curve analysis observed that patients in the high-risk group had a significantly shorter overall survival than those of the low-risk group. Receiver operating characteristic curve analysis demonstrated that this signature had high accuracy in predicting the 5-year overall survival and recurrence outcomes, respectively. LINC00652 may function by coexpressing with the above prognostic genes (INSL3, SNAP91, and REN) and lipid metabolism-related genes (MIA2, APOA1). Accordingly, this lncRNA-mRNA-based classifier may be clinically useful to predict the recurrence and prognosis for childhood ALL. These genes represent new targets to explain the mechanisms for ALL.

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 Down syndrome childhood acute lymphoblastic leukemia has a unique spectrum of sentinel cytogenetic lesions that influences treatment outcome: a report from the Children's Oncology Group

Blood ◽  
2010 ◽  
Vol 116 (7) ◽  
pp. 1045-1050 ◽  
Author(s):  
Kelly W. Maloney ◽  
William L. Carroll ◽  
Andrew J. Carroll ◽  
Meenakshi Devidas ◽  
Michael J. Borowitz ◽  
...  
Keyword(s):  
Overall Survival ◽  
Down Syndrome ◽  
Acute Lymphoblastic Leukemia ◽  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
Oncology Group ◽  
Blood Cell Count ◽  
Childhood All ◽  
Children With Down Syndrome ◽  
Increased Risk

Abstract Children with Down syndrome (DS) have an increased risk of acute lymphoblastic leukemia (ALL) and an inferior outcome. We reviewed data from 2811 children with ALL enrolled in Children's Oncology Group P9900, which included prospective testing for the major cytogenetic lesions in childhood ALL: ETV6-RUNX1, TCF3-PBX1, BCR-ABL1, and MLL translocations and trisomies of chromosomes 4 and 10. Eighty (3%) B-precursor ALL patients had DS. Age, sex, white blood cell count, and risk group were similar between DS-ALL and non–DS-ALL but significantly more patients with DS-ALL were white (91.2% vs 76.4%, P = .001). Children with DS-ALL had lower rates of the favorable cytogenetic lesions ETV6-RUNX1 (2.5% vs 24%, P < .001) and trisomies 4 and 10 (7.7% vs 24%, P < .001). Five-year event-free (EFS) and overall survival (OS) were inferior in children with DS-ALL: 69.9% ± 8.6% versus 78.1% ± 1.2% (P = .078), and 85.8% ± 6.5% versus 90.0% ± 0.9% (P = .033). However, when children with MLL translocations, BCR-ABL1, ETV6-RUNX1, and trisomies 4 and 10 were excluded, the EFS and OS were similar for children with and without DS (EFS 68.0 %± 9.3% vs 70.5% ± 1.9%, P = .817; and OS 86.7% ± 6.7% vs 85.4% ± 1.5%; P = .852), both overall and adjusted for race. DS-ALL displays a unique spectrum of biologic subtypes with different frequencies of sentinel cytogenetic lesions having a large influence on outcome.

Outcome of a Risk-Adapted Treatment for Childhood Acute Lymphoblastic Leukemia in Thailand.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2248-2248
Author(s):  
Issarang Nuchprayoon ◽  
Panya Seksarn ◽  
Preeda Vanichsetakul
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
T Cell ◽  
High Risk ◽  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
High Risk Group ◽  
Low Risk ◽  
Childhood All ◽  
Satisfactory Outcome ◽  
Standard Risk

Abstract Acute lymphoblastic leukemia (ALL) is the most curable cancer in children. In developing country with limited resource and manpower like Thailand, where 3 pediatris hematologists take care of 100 new cancer children per year, it is a challenge to achieve satisfactory outcome. We treated ALL according to a risk-adapted modified CCG-105 protocols (standard or intensive induction of remission, consolidation, 1800 cGy CNS radiation, and maintenance therapy with or without delayed intensification, DI) since 1988. We reported here the outcome of childhood ALL treated with this protocol between 1997–2004. 181 children with newly-diagnosed ALL in this period were classified into B-precursor, or T-cell ALL by immunophenotyping with flow cytometry. B-precursor ALL were classified as low risk group (age 1–10 yr and initial white cell count (WBC) <20,000/μl), standard-risk (age 1–10 yr and WBC between 20,000–50,000/μl) and high-risk (age >10 yr or WBC >50,000/μl). The low-risk group were assigned to protocol B (CCG-105 standard induction without DI, n=69). The standard- and high-risk group were assigned to protocol C (CCG-105 intensive induction with DI, n=71). All T-cell ALL (n=21) were assigned to a T-cell protocol (DFCI 85-01 high-risk group) which includes high-dose methotrexate and asparaginase. Infantile ALL (n=9), mature B-cell ALL (n=3), a child with t(1;19), and 5 children who refused treatment or received other protocols of treatment were excluded from analysis. The remission rates were 98.5% for protocol B, 92.4% for protocol C, and 83.3% for T-cell disease. All remission failure were attributed to early deaths. The 5-yr event-free survival (EFS ±95% confidence interval) was 83.1 ± .7% for low-risk group treated with protocol B, 75.9 ± 6.0% for protocol C, and 68.6 ± 12.1% for T-cell ALL. These outcomes are significantly higher than our previous report. (Nuchprayoon I, Songnui T, Vanichsetakul P, Seksarn P. Treatment of childhood acute lymphoblastic leukemia in Thailand- outcome and cost analysis. Blood 96 (11 suppl 1): 435a) and can be attributed to a better risk classification, more intensified treatment for standard-risk group and T-cell ALL, and better supportive care. Satisfactory outcome of childhood ALL can be achieved in developing country with risk-adapted treatment strategy. Figure Figure

scholarly journals “SOCIOECONOMIC FACTORS AFFECTING SURVIVAL IN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA FROM NORTH-EAST INDIA”

2020 ◽  
pp. 1-3
Author(s):  
Partha Sarathi Roy ◽  
Munlima Hazarika ◽  
Rakesh Kumar Mishra ◽  
BhargabJyoti Saikia ◽  
Gaurav Kumar
Keyword(s):  
Overall Survival ◽  
Developing Countries ◽  
Acute Lymphoblastic Leukemia ◽  
Socioeconomic Factors ◽  
Lymphoblastic Leukemia ◽  
Childhood All ◽  
Female Ratio ◽  
Risk Of Death ◽  
Lower Socioeconomic ◽  
Pediatric All

Acute lymphoblastic leukemia (ALL) is a highly curable childhood cancer with a survival rate of nearly 80% in developed countries but is around 45% in developing countries. This retrospective study analyzed the association between demographic and socioeconomic factors with survival in pediatric ALL. All confirmed cases of pediatric ALL (age <18 years) registered at Dr. B Borooah Cancer Institute between 2010 to 2017 were analyzed using data collected from hospital-based cancer registry and case records. Seventy-five confirmed cases of pediatrics ALL were eligible for the study. The median age of presentation was six years with a male: female ratio 1.9:1. Overall survival at 4-years was 43.8%, with a median survival of 25 months. A trend for higher 4-year overall survival was seen in female children (54.1% versus 37.9%, p=0.097). Patients from rural areas (44% versus 39.5%, p=0.308), with higher maternal education (83.3% versus 41.1%, p=0.161) and patients who did not abandon treatment (49.1% versus 31.2%, p=0.497) had better survival, but the differences were not significant. Four years overall survival in upper-middle, lower-middle, upper-lower, and lower class were 85.7%, 74.9%, 38.1%, and 7.7% respectively (upper-middleversus lower socioeconomic class, p=0.0001).Multivariate analyses confirmed a statistically significant relationship between socioeconomic status and survival, with the upper-middle group had a 90% decreased risk of death compared to the lower socioeconomic group. There is an urgent need for a proper definition of the problems of childhood ALL to introduce appropriate policies for improving survival in developing countries.

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.   

scholarly journals Prognostic factors in a multicenter study for treatment of acute lymphoblastic leukemia in adults

Blood ◽  
1988 ◽  
Vol 71 (1) ◽  
pp. 123-131 ◽  
Author(s):  
D Hoelzer ◽  
E Thiel ◽  
H Loffler ◽  
T Buchner ◽  
A Ganser ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Acute Lymphoblastic Leukemia ◽  
Median Survival ◽  
Multicenter Study ◽  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
High Risk Group ◽  
Remission Duration ◽  
First Remission ◽  
Adverse Factor

In a prospective multicenter study, 368 acute lymphoblastic leukemia (ALL) patients aged 15 to 65 years were treated with an intensified induction and reinduction regimen; 272 (73.9%) achieved complete remission (CR). The median remission duration (MRD) is 24.3 months, and the probability of being in continuous CR (CCR) at greater than 5 years is .37. The median survival for all 368 patients is 27.5 months, and the probability of being alive at 5 years is .39. For the 272 patients in remission the median survival is 58.4 months, and the probability of being alive at 5 years is .49. A lower CR rate was seen for patients with bleeding at diagnosis or with splenomegaly/hepatosplenomegaly. The prognostic factors unfavorable for remission duration were time to CR greater than 4 weeks v less than 4 weeks (P = .0002), age greater than 35 years v less than 35 years (P = .0008), leukocyte count greater than 30,000/microL v less than 30,000/microL (P = .0112), and null ALL v common ALL (c-ALL)/T cell ALL (T-ALL) (P = .05). The remission duration correlated strongly (P = .0001) with the number of these independent prognostic factors. In patients with none of these adverse factors the MRD has not yet been reached, with one adverse factor the MRD is 21.9 months, and with two or three adverse factors the MRD is only 9.6 months. For the immunologic subtype T-ALL, the probability of being in CCR at greater than 5 years is .55; for c-ALL, .34; and for null ALL, .24. According to these results, patients were stratified into a low- risk group with a CCR rate of .62 and a high-risk group with a CCR rate of .28, with the latter now allocated to either further chemotherapy or bone marrow transplantation in first remission.

scholarly journals A Five-MicroRNA Signature Predicts the Prognosis in Nasopharyngeal Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Shixiong Wu ◽  
Cen Zhang ◽  
Jing Xie ◽  
Shuang Li ◽  
Shuo Huang
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Nasopharyngeal Carcinoma ◽  
Receiver Operating Characteristic Curve ◽  
Operating Characteristic ◽  
Risk Group ◽  
Characteristic Curve ◽  
High Risk Group ◽  
Prognostic Signature ◽  
Operating Characteristic Curve

BackgroundThere is no effective prognostic signature that could predict the prognosis of nasopharyngeal carcinoma (NPC).MethodsWe constructed a prognostic signature based on five microRNAs using random forest and Least Absolute Shrinkage And Selection Operator (LASSO) algorithm on the GSE32960 cohort (N = 213). We verified its prognostic value using three independent external validation cohorts (GSE36682, N = 62; GSE70970, N = 246; and TCGA-HNSC, N = 523). Through principal component analysis, receiver operating characteristic curve analysis, and C-index calculation, we confirmed the predictive accuracy of this prognostic signature.ResultsWe calculated the risk score based on the LASSO algorithm and divided the patients into high- and low-risk groups according to the calculated optimal cutoff value. The patients in the high-risk group tended to have a worse prognosis outcome and chemotherapy response. The time-dependent receiver operating characteristic curve showed that the 1-year overall survival rate of the five-microRNA signature had an area under the curve of more than 0.83. A functional annotation analysis of the five-microRNA signature showed that the patients in the high-risk group were usually accompanied by activation of DNA repair and MYC-target pathways, while the patients in the low-risk group had higher immune-related pathway signals.ConclusionsWe constructed a five-microRNA prognostic signature, which could accurately predict the prognosis of nasopharyngeal carcinoma, and constructed a nomogram that could conveniently predict the overall survival of patients.

Treatment Outcome of Discontinued L-Asparaginase in Children with Standard-Risk Acute Lymphoblastic Leukemia: Tokyo Children’s Cancer Study Group (TCCSG) Study L99-15.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 878-878 ◽  
Author(s):  
Chitose Ogawa ◽  
Akira Ohara ◽  
Atsushi Manabe ◽  
Ryoji Hanada ◽  
Hiroyuki Takahashi ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
High Risk ◽  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
Risk Groups ◽  
High Risk Group ◽  
P Value ◽  
Group A ◽  
Group B ◽  
Standard Risk

Abstract BACKGROUND: L-asparaginase (L-asp) is one of the key drugs in the treatment of acute lymphoblastic leukemia (ALL) in children. However, L-asp often produces severe adverse effects including anaphylaxis resulting in its discontinuation. OBJECTIVE: To evaluate retrospectively the outcome of discontinuation of L-asp in patients with ALL. PATIENTS AND METHODS: Children newly diagnosed as ALL between 1999 and 2003 were consecutively enrolled on the TCCSG L99-15 study. Risk stratification was based on the age, initial white blood cell count, immunophenotype, cytogenetics and the response to prednisolone monotherapy. Totally, 267 (35%) out of 770 children were categorized into a standard-risk group (SR), 317 (41%) into a high-risk group (HR) and 186 (24%) into a very high-risk group (HEX). Allogeneic stem cell transplantation was indicated approximately in 50% of the HEX patients. L-asp was used 9 times in the induction phase in all the risk groups. The total number of L-asp administration all through the treatment was 19 in SR, 20 in HR and at least 10 in HEX. Patients were divided into two groups in the analysis: group A patients who received at least 50% of scheduled doses of L-asp and group B patients who received less than 50%. RESULTS: Remission was obtained in 259 (97%) patients in SR, 311 (98%) in HR and 171(92%) in HEX. In the patients who achieved remission and were analyzed, 195 (83.7%) in SR, 223 (78.8%) in HR and 123 (83.7%) in HEX received all the scheduled doses of L-asp. Event-free survival (EFS) (SE) and overall survival (OS) (SE) at 5 years for all the risk groups are shown in the table. Notably, EFS in group A (92.9%) and in group B (74.1%) in SR was significantly different (p=0.025). CONCLUSION: The outcome in patients who received less than 50% of scheduled dose of L-asp was inferior to that in the patients who received more than 50% of the scheduled dose. This suggests that modification or intensification of the treatment should be considered for the patients who discontinued L-asp in SR. EFS and OS in each group Risk group EFS ± SE(%) OS ± SE(%) (No. in A /B) group A group B p value group A group B p value SR (223 /10) 92.9±2.4 74.1±16.1 0.025 97.8±1.1 88.9±10.5 0.066 HR (269 /14) 78.5±3.2 66.7±19.2 0.969 88.9±2.6 50.0±25.0 0.158 HEX (142 /5) 58.2±5.5 75.5±21.7 0.514 75.6±4.3 80.0±17.9 0.873

scholarly journals ANALISIS KADAR KREATININ PADA ANAK DENGAN LEUKEMIA LIMFOBLASTIK AKUT DI PUSAT KANKER ANAK ESTELLA BLU RSUP PROF DR RD KANDOU

e-CliniC ◽  
2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Fajrul Falakh Tamsil
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
High Risk ◽  
Risk Group ◽  
Lymphoblastic Leukemia ◽  
High Risk Group ◽  
Good Effect ◽  
Result Show ◽  
The Impact ◽  
Standard Risk ◽  
Common Malignancy

Abstract: Malignant disease in children is one cause of death in the age group of children. Characteristic of the spread and prognosis of malignancy in children is very different with malignancy in adult. Acute Lymphoblastic Leukemia is the most common malignancy in children. Treatment with chemotherapy gifts a good effect in recent years, characterized by a decrease in mortality. How ever, as a vital organ that has function to stabilizer and organ disposal of substances that are not useful and toxic, surely chemotherapy effect on the health of kidney function. The impact of chemotherapy on renal function can be determined by examination of creatinne levels in children undergoing chemotherapy. The purpose of this study is to determine the levels of creatinine in children with acute lymphoblastic leukemia undergoing therapy in Estella Room BLU RSUP Prof Dr RD Kandou Manado. Characteristic of this study is descriptive analytic with retrospectional approach, this case done by taking patient’s medical record data from September 2012-2013. Samples were 30. Conclusion:The result obtained from 30 samples contain as many as 16 samples had normal creatinine levels, and 14 samples had not normal creatinine levels, which consisted of 15 samples with a high risk group, an 15 sample with standard risk group. Bivariat analysis result show the value of P=0.642. From this result, it can be concluded that there is no differences between creatinine levels in children with high risk group and children with standard risk group. Keywords: Acute Lymphoblastic Leukemia, Creatinine, Child    Abstrak:Penyakit keganasan pada anak merupakan salah satu penyebab utama kematian pada kelompok umur anak.Kanker pada anak sangat berbeda dengan keganasan pada orang dewasa dalam sifat, penyebaran dan prognosis.Leukimia Limfoblastik Akut merupakan keganasan yang paling sering terjadi pada anak.Penanganan dengan kemoterapi memberikan efek yang baik dalam beberapa tahun terakhir, ditandai dengan penurunan angka mortalitas.Namun sebagai organ vital yang memiliki fungsi sebagai pengatur keseimbangan dan organ pembuangan zat-zat yang tidak berguna serta bersifat toksik, tentunya kemoterapi memberikan efek terhadap kesehatan fungsi ginjal. Dampak kemoterapi terhadap fungsi ginjal dapat diketahui dengan pemeriksaan kadar kreatinin pada anak yang menjalani kemoterapi. Tujuan penelitian ini untuk mengetahui  kadar kreatinin pada anak dengan leukemia limfoblastik akut yang menjalani terapi di Ruang Estella BLU RSUP Prof. DR. R.D Kandou.Penelitian ini bersifat deskriptif analitik dengan pendekatan retrospektional, dalam hal ini dilakukan dengan pengambilan data rekam medik pasien sejak September 2012-2013. Sampel berjumlah 30 orang. Simpulan : Hasilyang didapatkan dari 30 orang sampel, terdapat sebanyak 16 sampel yang memiliki kadar kreatinin yang normal, dan 14 sampel yang memiliki kadar kreatinin yang tidak normal, yang terdiri dari 15 sampel dengan kelompok resiko tinggi(High Risk), dan 15 sampel dengan kelompok resiko standar (Standard Risk). Hasil analisis bivariat menunjukkan nilai p=0,642. Dari hasil penelitian ini dapat disimpulkan bahwa tidak adaperbedaan kadar kreatinin pada anak kelompok resiko tinggi (High Risk) LLA, dengan resiko standard (Standard Risk) LLA Kata Kunci: Leukemia Limfoblastik Akut, Kadar Kreatinin, Anak.

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