Analisis skor hasford sebagai prediktor respons molekuler mayor pada penderita chronic myeloid leukemia yang mendapat terapi nilotinib
Abstract
Abstrak. Pendahuluan: Chronic myeloid leukemia (CML) merupakan neoplasma myeloproliferative clonal ditandai dengan ekspansi sel punca sumsum tulang pluripoten yang tidak terkendali. Saat ini Tyrosine Kinase Inhibitor (TKI) digunakan sebagai terapi untuk pasien CML fase kronik. Nilotinib adalah TKI generasi kedua yang diberikan pada pasien CML yang gagal memberikan respons terapi pada pemberian TKI generasi pertama. Skor Hasford merupakan skor prediktor prognostik dan dapat digunakan untuk menilai respons terapi, termasuk respons molekuler. Penelitian ini bertujuan untuk menilai hubungan skor Hasford terhadap respons molekuler mayor (RMM) pada penderita CML yang mendapat terapi nilotinib. Metode: Penelitian ini merupakan studi observasional komparatif kategorik dengan desain potong lintang yang dilakukan di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh. Skor Hasford dihitung berdasarkan formula yang menggunakan usia pasien, ukuran limpa, jumlah trombosit, eosinofil, basofil, dan jumlah blast darah. Pemeriksaan BCR-ABL1 kuantitatif digunakan sebagai penanda RMM. Data dianalisis dengan menggunakan Chi-square test dan Fisher exact test. Kedua variabel yang dianalisis dinyatakan berhubungan apabila memiliki p-value < 0,05. Hasil: Sebanyak 15 penderita CML yang mendapat terapi nilotinib terlibat dalam penelitian ini dengan distribusi skor Hasford 11 pasien (risiko rendah), 4 pasien (risiko sedang), dan 0 pasien (risiko berat). RMM didapatkan pada 3 pasien (20%) dari keseluruhan jumlah sampel. Tidak terdapat adanya hubungan antara skor Hasford dengan RMM pada pasien CML fase kronik yang mendapat terapi nilotinib dengan nilai p-value 0.637. Kesimpulan: Tidak terdapat hubungan antara skor Hasford dengan RMM pada pasien CML fase kronik yang mendapat terapi nilotinib.
Kata kunci: CML, skor Hasford, nilotinib, respons molekuler mayor, RMM
Abstract. Introduction: Chronic myeloid leukemia (CML) is a clonal myeloproliferative neoplasm characterized by uncontrolled expansion of pluripotent bone marrow stem cells. Currently, Tyrosine Kinase Inhibitors (TKIs) are used as therapy for chronic phase CML patients. Nilotinib is a second-generation TKI given to CML patients who fail to respond to therapy with the first-generation TKI. The Hasford score is a prognostic predictor score and can be used to assess response to therapy, including molecular response. This study aimed to assess the relationship between the Hasford score and the major molecular response (MMR) in CML patients receiving nilotinib therapy. Methods: This research is a categorical comparative observational study with a cross-sectional design conducted at the Regional General Hospital dr. Zainoel Abidin Banda Aceh. The Hasford score is calculated based on a formula that uses the patient's age, spleen size, platelet count, eosinophils, basophils, and blood blast count. Quantitative BCR-ABL1 assay was used as a marker of MMR. Data were analyzed using Chi-square test and Fisher exact test. The two variables analyzed are stated to be correlated if they have a p-value <0.05. Results: A total of 15 patients with CML who received nilotinib therapy were involved in this study with a Hasford score distribution of 11 patients (low risk), 4 patients (moderate risk), and 0 patients (severe risk). MMR was obtained in 3 patients (20%) of the total sample. There was no relationship between Hasford score and MMR in chronic phase CML patients receiving nilotinib therapy with p-value of 0.637. Conclusion: There was no relationship between Hasford score and MMR in chronic phase CML patients receiving nilotinib therapy.
Keywords: CML, Hasford score, nilotinib, major molecular response, MMR
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DOI: 10.24815/jks.v23i1.31236
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