Children with Standard Risk Acute Lymphoblastic Leukemia in Induction And Consolidation Phase
Prednisone has an important role in the therapy of patient with standard risk ALL. Patients with standard risk ALL receiving high dose prednisone as therapy and supraphysiology dose of prednisone are expected to cause suppression in HPA-axis (Hypothalamic Pituitary Adrenal axis). This suppression co...
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| Format: | Article |
| Language: | English |
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Universitas Airlangga
2018-04-01
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| Series: | Folia Medica Indonesiana |
| Subjects: | |
| Online Access: | https://e-journal.unair.ac.id/FMI/article/view/8054 |
| _version_ | 1811230101959868416 |
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| author | Adinugraha Amarullah Didik Hasmono IGD Ugrasena Yulistiani Yulistiani |
| author_facet | Adinugraha Amarullah Didik Hasmono IGD Ugrasena Yulistiani Yulistiani |
| author_sort | Adinugraha Amarullah |
| collection | DOAJ |
| description | Prednisone has an important role in the therapy of patient with standard risk ALL. Patients with standard risk ALL receiving high dose prednisone as therapy and supraphysiology dose of prednisone are expected to cause suppression in HPA-axis (Hypothalamic Pituitary Adrenal axis). This suppression could reduce immune system in children with ALL and increase infection risk because reduction of cortisol level. In Indonesia, we did not find study about the incident of adrenal suppression after high dose prednisone therapy, especially in induction to consolidation phase ALL patient. The aim of this study was to analyze adrenal suppression after high dose prednisone therapy on children with standard risk acute lymphoblastic leukemia in induction and consolidation phase. This study has received a certificate of Ethical Clearance No. 588/Panke.KKE/X/2016, a longitudinal observational, prospective, non-randomized trial involving children with ALL who received prednisone for 49 days during the induction phase. We collected and compared laboratory result of cortisol level in children with ALL and received prednisone therapy during induction to consolidation phase. Sample was taken at week 0,4,5,6,7,8,10,12 in the course of ALL chemotheraphy Indonesian protocol year 2013. Serum was examined using methods CLIA ADVIA Centaur® XP. Between June 2016 – January 2017, 13 patients (8 males, 5 females) were included in this study. Decrease of cortisol level after prednisone therapy occured in week-10 as much as 53% compared with week-0 (p=0.027). Cortisol level increased 64% of week-12 compared with week-10 (p=0.003). In conclusion, high dose prednisone is not significant to causing adrenal suppression in induction phase of ALL patients, and the reducing cortisol level is reversible. |
| first_indexed | 2024-04-12T10:24:31Z |
| format | Article |
| id | doaj.art-25ba03ad0fc84837a00f5ace3fa023eb |
| institution | Directory Open Access Journal |
| issn | 2355-8393 2599-056X |
| language | English |
| last_indexed | 2024-04-12T10:24:31Z |
| publishDate | 2018-04-01 |
| publisher | Universitas Airlangga |
| record_format | Article |
| series | Folia Medica Indonesiana |
| spelling | doaj.art-25ba03ad0fc84837a00f5ace3fa023eb2022-12-22T03:37:00ZengUniversitas AirlanggaFolia Medica Indonesiana2355-83932599-056X2018-04-01541596310.20473/fmi.v54i1.80544392Children with Standard Risk Acute Lymphoblastic Leukemia in Induction And Consolidation PhaseAdinugraha Amarullah0Didik Hasmono1IGD Ugrasena2Yulistiani Yulistiani3Department of Clinical Pharmacy, Faculty of Pharmacy, Universitas Airlangga, SurabayaClinical Pharmacy Department, Faculty of Pharmacy, Universitas Airlangga, SurabayaPediatric Department, Dr. Soetomo Hospital SurabayaClinical Pharmacy Department, Faculty of Pharmacy, Universitas Airlangga, SurabayaPrednisone has an important role in the therapy of patient with standard risk ALL. Patients with standard risk ALL receiving high dose prednisone as therapy and supraphysiology dose of prednisone are expected to cause suppression in HPA-axis (Hypothalamic Pituitary Adrenal axis). This suppression could reduce immune system in children with ALL and increase infection risk because reduction of cortisol level. In Indonesia, we did not find study about the incident of adrenal suppression after high dose prednisone therapy, especially in induction to consolidation phase ALL patient. The aim of this study was to analyze adrenal suppression after high dose prednisone therapy on children with standard risk acute lymphoblastic leukemia in induction and consolidation phase. This study has received a certificate of Ethical Clearance No. 588/Panke.KKE/X/2016, a longitudinal observational, prospective, non-randomized trial involving children with ALL who received prednisone for 49 days during the induction phase. We collected and compared laboratory result of cortisol level in children with ALL and received prednisone therapy during induction to consolidation phase. Sample was taken at week 0,4,5,6,7,8,10,12 in the course of ALL chemotheraphy Indonesian protocol year 2013. Serum was examined using methods CLIA ADVIA Centaur® XP. Between June 2016 – January 2017, 13 patients (8 males, 5 females) were included in this study. Decrease of cortisol level after prednisone therapy occured in week-10 as much as 53% compared with week-0 (p=0.027). Cortisol level increased 64% of week-12 compared with week-10 (p=0.003). In conclusion, high dose prednisone is not significant to causing adrenal suppression in induction phase of ALL patients, and the reducing cortisol level is reversible.https://e-journal.unair.ac.id/FMI/article/view/8054Standard risk acute lymphoblastic leukemiacortisol levelsadrenal suppressionprednisoneinduction phase chemotherapyconsolidation phase chemotherapy |
| spellingShingle | Adinugraha Amarullah Didik Hasmono IGD Ugrasena Yulistiani Yulistiani Children with Standard Risk Acute Lymphoblastic Leukemia in Induction And Consolidation Phase Folia Medica Indonesiana Standard risk acute lymphoblastic leukemia cortisol levels adrenal suppression prednisone induction phase chemotherapy consolidation phase chemotherapy |
| title | Children with Standard Risk Acute Lymphoblastic Leukemia in Induction And Consolidation Phase |
| title_full | Children with Standard Risk Acute Lymphoblastic Leukemia in Induction And Consolidation Phase |
| title_fullStr | Children with Standard Risk Acute Lymphoblastic Leukemia in Induction And Consolidation Phase |
| title_full_unstemmed | Children with Standard Risk Acute Lymphoblastic Leukemia in Induction And Consolidation Phase |
| title_short | Children with Standard Risk Acute Lymphoblastic Leukemia in Induction And Consolidation Phase |
| title_sort | children with standard risk acute lymphoblastic leukemia in induction and consolidation phase |
| topic | Standard risk acute lymphoblastic leukemia cortisol levels adrenal suppression prednisone induction phase chemotherapy consolidation phase chemotherapy |
| url | https://e-journal.unair.ac.id/FMI/article/view/8054 |
| work_keys_str_mv | AT adinugrahaamarullah childrenwithstandardriskacutelymphoblasticleukemiaininductionandconsolidationphase AT didikhasmono childrenwithstandardriskacutelymphoblasticleukemiaininductionandconsolidationphase AT igdugrasena childrenwithstandardriskacutelymphoblasticleukemiaininductionandconsolidationphase AT yulistianiyulistiani childrenwithstandardriskacutelymphoblasticleukemiaininductionandconsolidationphase |