Korelasi skor sokal terhadap respons molekuler mayor pada penderita chronic myeloid leukemia yang mendapat terapi nilotinib
Abstract
Abstrak. Chronic Myeloid Leukemia (CML) adalah penyakit mieloproliferatif dengan peningkatan proliferasi sel induk hematopoietik seri mieloid pada berbagai stadium diferensiasi. 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 Sokal merupakan skor prediktor prognostik dan dapat digunakan untuk menilai respons terapi, termasuk respons molekuler. Penelitian ini bertujuan untuk menilai korelasi skor Sokal terhadap respon molekuler mayor pada penderita CML yang mendapat terapi nilotinib. Penelitian ini merupakan studi korelatif dengan desain potong lintang yang dilakukan di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh. Skor Sokal dihitung berdasarkan formula yang menggunakan usia pasien, ukuran limpa, jumlah trombosit, dan jumlah blast darah. Pemeriksaan BCR-ABL kuantitatif digunakan sebagai penanda respons molekuler mayor. Data dianalisis dengan menggunakan Chi-square test dan Fisher exact test. Kedua variabel yang dianalisis dinyatakan berkorelasi apabila memiliki p-value < 0,05. Sebanyak 15 penderita CML yang mendapat terapi nilotinib terlibat dalam penelitian ini dengan distribusi skor Sokal 10 orang (risiko rendah), 4 orang (risiko sedang), dan 1 orang (risiko berat). Respons molekuler mayor didapatkan pada 3 orang (20%) dari keseluruhan jumlah sampel. Tidak terdapat adanya korelasi antara skor Sokal dengan respons molekuler mayor pada pasien CML yang mendapat terapi nilotinib dengan nilai p value 0.604.
Kata kunci: CML, skor sokal, MMR
Abstract. Chronic Myeloid Leukemia (CML) is a myeloproliferative disease characterized by increased proliferation of myeloid series at various stages of differentiation. Tyrosine Kinase Inhibitors (TKIs) are used as therapy for patients with CML. Nilotinib is a second-generation TKI given to CML patients who fail to respond to the first-generation TKI. Sokal score is a prognostic predictor score and can be used to assess therapeutic responses, including molecular response. This study aimed to assess the correlation of Sokal score to major molecular response in CML patients receiving nilotinib. This is a cross-sectional correlative study conducted at the dr. Zainoel Abidin General Hospital Banda Aceh. Sokal score is calculated based on formula that uses patient's age, spleen size, platelet count, and blood blast count. Quantitative BCR-ABL assay was used as marker of major molecular responses. Data were analyzed using Chi-square test and Fisher exact test. The two variables analyzed are stated to be correlated if p-value <0.05.
A total of 15 patients with CML who received nilotinib were involved in this study with Sokal score distribution of 10 people (low risk), 4 people (moderate risk), and 1 person (severe risk). The achievement of a major molecular response was obtained in 3 people (20%) of the total sample. There was no correlation between Sokal scores and major molecular responses in CML patients receiving nilotinib with p value 0.604.
Keywords: CML, sokal score, MMR
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DOI: 10.24815/jks.v23i1.31376
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