Petanda Imunofenotip CD10 Sendiri Atau Bersama CD3 Atau CD13/CD33 sebagai Faktor Prognosis Luaran Terapi Fase Induksi Leukemia Limfoblastik Akut Anak
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Latar belakang. Kegagalan terapi masih menjadi penyumbang terbesar bagi mortalitas anak dengan leukemia limfoblastik akut (LLA). Ekspresi CD10 menentukan diferensiasi sebagian besar leukemia sel B. Petanda imunofenotip untuk LLA sel T, yaitu CD3, dan myeloid antigen, yaitu CD13/CD33, dengan jumlah kecil juga terekspresi pada B-ALL.
Tujuan. Mengetahui pengaruh ekspresi CD10 sendiri atau bersama dengan CD3 atau CD13/CD33 terhadap luaran terapi fase induksi LLA anak.
Metode. Desain penelitian menggunakan nested case-control. Sampel penelitian merupakan pasien LLA anak yang baru terdiagnosis di INSKA RSUP Dr Sardjito Yogyakart Januari 2006-Desember 2009, dilengkapi pemeriksaan imunofenotip saat penegakan diagnosis. Analisis bivariat dan multivariat digunakan untuk menentukan faktor prognosis independen terhadap luaran terapi.
Hasil. Seratus enam puluh tujuh pasien diikutsertakan dalam penelitian ini. Faktor usia dan ekspresi CD10 merupakan faktor prognosis independen yang menentukan luaran terapi fase induksi. Kelompok usia <1 tahun dan >10 tahun akan mengalami gagal remisi (OR 3,1; IK95%: 1,271-7,625; p=0,013), dan LLA anak dengan CD10 negatif akan mengalami gagal remisi 2,7 kali lebih tinggi dibanding CD10 positif (IK95%: 1,171-6,232; p=0,020).
Kesimpulan. CD10 negatif merupakan faktor prognosis independen terhadap kejadian gagal remisi. Ekspresi imunofenotip CD10 bersama CD3 dan CD13/CD33, bukan merupakan faktor prognosis bagi luaran terapi fase induksi.
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DOI: http://dx.doi.org/10.14238/sp19.5.2018.260-6
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