Amaylia Oehadian
Division of Hematology and Medical Oncology Universitas Padjadjaran Dr. Hasan Sadikin General Hospital

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PERBEDAAN EKSPRESI VASCULAR ENDOTHELIAL GROWTH FACTOR DAN EKSPRESI TISSUE FACTOR BERDASARKAN RESPONS TERAPI KEMORADIASI CISPLATIN PADA PENDERITA KARSINOMA NASOFARING STADIUM LANJUT Hendarsih, Een; Oehadian, Amaylia; Sumantri, Rachmat; Supandiman, Iman; Hernowo, Bethy S.
Majalah Kedokteran Bandung Vol 47, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Vascular endothelial growth factor (VEGF) merupakan faktor angiogenik yang berperan dalam angiogenesis tumor. Tissue factor (TF) merupakan inisiator utama pembekuan darah dan merangsang protein yang mengatur angiogenesis. Penelitian bertujuan mengetahui perbedaan ekspresi VEGF dengan ekspresi TF pada penderita KNF stadium lanjut berdasarkan respons terapi kemoradiasi. Dilakukan penelitian kohort prospektif pada penderita KNF stadium III, IVa, dan IVb berdasarkan AJCC edisi ke-7 tahun 2010. Ekspresi TF dan VEGF diperiksa dengan imunohistokimia dan respons kemoradioterapi dievaluasi dengan memakai Response Evaluation Criteria in Solid Tumours (RECIST) revisi versi 1.1 tahun 2009. Analisis statistik yang digunakan adalah Uji eksak Fisher. Selama penelitian Oktober 2012?Oktober 2013 didapatkan 35 penderita KNF yang memenuhi kriteria inklusi dan 5 orang dikeluarkan dari penelitian. Pada kelompok respons didapatkan 17 dari 23 penderita ekspresi VEGF ? 25%; 6 dari 23 penderita ekspresi VEGF <25%; 16 dari 23 penderita ekspresi TF ? 33%; 7 dari 23 penderita ekspresi TF <33% (p=1,000) serta pada kelompok tidak respons 5 dari 27 penderita ekspresi VEGF ?25%; 2 dari 7 penderita ekspresi VEGF <25%; 4 dari 7 penderita ekspresi TF ? 33%; 3 dari 7 penderita ekspresi TF <33% (p=0,657). Simpulan, tidak terdapat perbedaan ekspresi VEGF dengan ekspresi TF pada penderita KNF stadium lanjut berdasarkan respons terapi kemoradiasi. [MKB. 2015;47(1):49?54]Kata kunci: Karsinoma nasofaring, respons kemoradiasi, tissue factor, vascular endothelial growth factorDifferences between Vascular Endothelial Growth Factor Expression and Tissue Factor Expression Based on Cisplatin Chemoradiation Therapy Response in Advanced Stage Nasopharyngeal CancerVascular endothelial growth factor (VEGF) is a proangiogenic factor involved in the angiogenesis of NPC. Tissue factor (TF), the main initiator of blood coagulation, also signals protein that regulates angiogenesis. This study  analyzed the differences between VEGF expression and TF expression in tumor tissue based on chemoradiation therapy response. Prospective cohort study was performed in NPC patients stage III, IVa and IVb according to the AJCC VII staging system. TF expression and VEGF expression were measured by immunohistochemistry, and chemoradiotherapy responses was evaluated by RECIST version 1.1 2009. Statistical analysis was performed using Fisher Exact test. From October 2012 to October 2013, 35 NPC patients were eligible for this study and 5 patients were excluded. In response group, there were 73.9% patients with VEGF expression ?25%, 26.1% patients with VEGF expression <25%; 69.6% patients with TF expression ?33%, 30.4% patients with TF expression <33% (p=1,000) and in no response group, there were 71,4% patients with VEGF expression ? 25%; 28.6% patients with VEGF expression <25%, 57.1% patients with TF expression  ?33%, 42.9% patients with TF expression <33% (p=0.657). In conclusion, there are differences between VEGF expression and TF expression based on the chemoradiation therapy response, but they are not significantly different. [MKB. 2015;47(1):49?54]Key words: Nasopharyngeal carcinoma, chemoradiation response, tissue factor, vascular endothelial growth factor DOI: 10.15395/mkb.v47n1.397   
GAMBARAN EGFR MENURUT CKD-EPI PADA PENDERITA THALASSEMIA MAYOR DI RUMAH SAKIT DR. HASAN SADIKIN BANDUNG Doloksaribu, Rismauli; Husna, Rizka; Oehadian, Amaylia
Majalah Kedokteran Bandung Vol 49, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v49n1.980

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Peningkatan harapan hidup penderita thalassemia menyebabkan manifestasi penyakit pada berbagai organ, termasuk ginjal. Estimated glomerular filtration rate (eGFR) adalah penghitungan untuk mendeteksi gangguan dini fungsi ginjal, cara ini lebih dipercaya dibandingkan nilai kreatinin serum. The National Kidney Foundation merekomendasikan Chronic Kidney Disease  Epidemiology Collaboration (CKD-EPI) untuk mengestimasi laju filtrasi glomerulus. Penelitian ini bertujuan mengetahui gambaran eGFR menurut CKD-EPI  pasien thalassemia. Penelitian menggunakan metode deskriptif. Data diambil dari penderita thalassemia mayor rawat jalan di Klinik  Hematologi Onkologi Medik, Rumah Dr. Sakit Hasan Sadikin Bandung, mulai 1 Februari sampai dengan 31 Maret 2016. Diperiksa kadar kreatinin serum dan penghitungan eGFR berdasar atas CKD-EPI. Dari 108 subjek penelitian, didapatkan usia rata-rata 18 tahun dengan jumlah wanita sebanyak 61,1 %. Gambaran eGFR berdasarkan CKD-EPI: menunjukkan hiperfiltrasi glomerulus pada mayoritas pasien dengan eGFR >120 mL/menit.  Pemeriksaan fungsi ginjal pasien thalassemia diperlukan untuk memantau gangguan fungsi ginjal dan untuk pemilihan penggunaan jenis kelasi besi. [MKB. 2016;49(1):22?7]Kata kunci: CKD?EPI, eGFR, thalassemia eGFR Profile Based on CKD-EPI of Thalassemia Mayor Patients in Dr. Hasan Sadikin General Hospital BandungIncreased life expectancy of thalassemia patients has a consequence of various manifestations of the diseases in many organs including kidney. Estimated glomerular filtration rate (eGFR) can be used for detecting early renal dysfunctions due to the fact that this calculation is more accurate compared to creatinine serum measurement. The National Kidney Foundation recommends Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) for estimating GFR. The aim of this descriptive study was to describe eGFR profile based on CKD-EPI in thalassemia patients. Data were collected from ambulatory patients visiting the Hematology Oncology Medical Clinic of Dr. Hasan Sadikin General Hospital during the period of February 1, 2016 to March 31, 2016. Subjects were patients with thalassemia major. Creatinine serum level  and calculated eGFR based on CKD-EPI were evakyated.  One hundred and eightsubjects with a median age of 18 years participated in this study with 61.1%  of them were female. According to the Kidney Disease Improving Global Outcomes  ( KDIGO) 2012, the eGFR calculation based on CKD-EPI showed that the majority of patients experience glomerular hyperfiltration (eGFR >120 ml/mnt). In this study, most Thalassemia major patients showed glomerular hyperfiltration. Renal function test is needed to monitor renal function abnormalities and to choose  the type of iron chelation therapy to be implemented. [MKB. 2016;49(1):22?7]Key words: CKD-EPI, eGFR, thalassemia
Overview of Anemia among Systemic Lupus Erythematosus Patients in Reproductive Age Women based on Reticulocyte Hemoglobin Equivalent (RET-He) Level and Reticulocyte Count Modjaningrat, Ismiana Fatimah; Oehadian, Amaylia; Ghozali, Mohammad; Hamijoyo, Laniyati
Indonesian Journal of Rheumatology Vol 9, No 2 (2017)
Publisher : Indonesian Rheumatology Association

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Background: Anemia is a common manifestation found among patients with Systemic Lupus Erythematosus (SLE). It may be caused by iron-deficiency, autoimmune hemolytic, and chronic inflammation. Each anemia has different therapy approachments. Without adequatemanagement, anemia may lead to poor prognosis. By identifying the etiology of anemia, appropriate management could be conducted. Reticulocyte Hemoglobin Equivalent (RET-He) and reticulocyte count test may distinguish anemia based on its etiology. This study aimed to give scientific portrayed of the proportion of anemia based on its etiology among patients with SLE using RET-He and reticulocyte count.Method: This study involved women diagnosed with SLE underwent outpatient treatment in Rheumatology Clinic, Dr. Hasan Sadikin General Hospital during SeptemberOctober 2016. Data were collected from blood exam using 35-parameters hematology Sysmex by calculating levels of hemoglobin, RET-He, and reticulocyte count.Results: Seventy four female patients were volunteered as subject in this study with median of age was 29.5 (16-70) years old. Thirty four (46%) of 74 subjects weresuffering from anemia and 12 (35%) of them were between 25-34 years old. Proportion of iron-deficiency anemia, autoimmune hemolytic anemia, and chronic inflammatory anemia were 14 ( 41%), 13 (38%), and 7 (21%), respectively.Conclusion: Based on hemoglobin, RET-He, and reticulocyte count, iron-deficiency anemia is the most common anemia among patients with SLE in repoductive age.Keyword: Age, Anemia, Reticulocyte, RET-He, Systemic Lupus Erythematosus (SLE)
Overview of Anemia among Systemic Lupus Erythematosus Patients in Reproductive Age Women based on Reticulocyte Hemoglobin Equivalent (RET-He) Level and Reticulocyte Count Modjaningrat, Ismiana Fatimah; Oehadian, Amaylia; Ghozali, Mohammad; Hamijoyo, Laniyati
Indonesian Journal of Rheumatology Vol 9 No 2 (2017)
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (240.978 KB)

Abstract

Background: Anemia is a common manifestation found among patients with Systemic Lupus Erythematosus (SLE). It may be caused by iron-deficiency, autoimmune hemolytic, and chronic inflammation. Each anemia has different therapy approachments. Without adequatemanagement, anemia may lead to poor prognosis. By identifying the etiology of anemia, appropriate management could be conducted. Reticulocyte Hemoglobin Equivalent (RET-He) and reticulocyte count test may distinguish anemia based on its etiology. This study aimed to give scientific portrayed of the proportion of anemia based on its etiology among patients with SLE using RET-He and reticulocyte count.Method: This study involved women diagnosed with SLE underwent outpatient treatment in Rheumatology Clinic, Dr. Hasan Sadikin General Hospital during SeptemberOctober 2016. Data were collected from blood exam using 35-parameters hematology Sysmex by calculating levels of hemoglobin, RET-He, and reticulocyte count.Results: Seventy four female patients were volunteered as subject in this study with median of age was 29.5 (16-70) years old. Thirty four (46%) of 74 subjects weresuffering from anemia and 12 (35%) of them were between 25-34 years old. Proportion of iron-deficiency anemia, autoimmune hemolytic anemia, and chronic inflammatory anemia were 14 ( 41%), 13 (38%), and 7 (21%), respectively.Conclusion: Based on hemoglobin, RET-He, and reticulocyte count, iron-deficiency anemia is the most common anemia among patients with SLE in repoductive age.Keyword: Age, Anemia, Reticulocyte, RET-He, Systemic Lupus Erythematosus (SLE)
Therapeutic Responses of Imatinib and Nilotinib among CML Patients in Hasan Sadikin Hospital Bandung Sumantri, Agung Firmansyah; Oehadian, Amaylia; Wijaya, Indra; Vidyaniati, Putri; Rahmaniati, Rahmaniati
Indonesian Journal of Cancer Vol 12, No 3 (2018): July-September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (843.37 KB) | DOI: 10.33371/ijoc.v12i3.615

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Introduction: Chronic Myeloid Leukemia (CML) is a myeloproliferative malignancy with an estimated incidence in the world of 1-2 cases per 100,000 adults. The use of Tyrosine Kinase Inhibitors (TKI) as a therapy for CML is still the first choice for treatment, but some cases show a high level of resistance or intolerance to TKI therapy. This study aims to identify the therapeutic responses of imatinib and nilotinib among CML patients in Bandung.Method: This study is an analytical descriptive study of CML patients at Hasan Sadikin Hospital’s Hematology and Medical Oncology Outpatient Clinic in 2017. The total number of samples in this study is 244 patients, consisting of 199 patients with Imatinib therapy and 45 patients with Nilotinib therapy. The data is processed using SPSS Statistics 22.0 software.Result: The results showed that CML patients had a median age of 42 years, sex ratio of 1: 1 and the highest prevalence was in Bandung City (21.3%). Hematologic response is dominated by complete hematologic response, as high as 72.86% with Imatinib and 66.67% with Nilotinib. Molecular response 3-6 months post therapy is dominated by suboptimal response in as many as 36,8% with Imatinib and failure in as many as 50% with Nilotinib. Molecular response 12-18 months post therapy is dominated by failure in as high as 69,4% with Imatinib and 52,4% with Nilotinib.Conclusion: Based on the molecular response, the rates of suboptimal response and resistance are quite high. Regular monitoring standards of therapy for CML patients are needed to identify TKI resistance so alternative therapies can be provided to improve the outcomes.
HYPERCOAGULABLE STATE DAN DIABETES MELITUS TIPE 2: KORELASI ANTARA FIBRINOGEN DAN HBA1C Aprijadi, Hery; Sumantri, Rachmat; Heri, Trinugroho; Irani, Pandji; Oehadian, Amaylia; Arifin, Augusta Y. L.
Majalah Kedokteran Bandung Vol 46, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Hiperkoagulabilitas merupakan penyebab kelainan vaskular pada diabetes melitus tipe 2 (DM tipe 2). Fibrinogen merupakan petanda hiperkoagulabilitas akibat inflamasi sistemik. Kadar HbA1c dipakai untuk menilai kadar gula darah jangka panjang dan berhubungan dengan petanda inflamasi. Terdapat perbedaan hasil penelitian terdahulu tentang bagaimana hubungan antara kadar fibrinogen dan HbA1c. Ada yang menyatakan hubungan bermakna dan ada pula yang tidak. Tujuan penelitian ini untuk melihat adakah korelasi antara fibrinogen dan HbA1c. Penelitian ini merupakan penelitian potong lintang pada penderita rawat jalan DM tipe 2 di RS Dr. Hasan Sadikin Bandung selama Januari?Juli 2010. Kriteria inklusi penderita DM tipe 2 yang baru didiagnosis, normotensi, kadar hemoglobin normal, serta tes fungsi hati dan ginjal normal. Dilakukan pemeriksaan kadar fibrinogen, trigliserida, dan HbA1c. Kriteria eksklusi yaitu mendapat obat antiagregasi trombosit, obat antidiabetik oral, atau menderita penyakit autoimun. Analisis statistik berupa Spearman dan regresi digunakan pada penelitian ini. Terdapat 63 subjek yang diikutkan dalam penelitian. Semua subjek memiliki kadar HbA1c lebih dari 6,5% (rata-rata 8,21±2,5%). Terdapat 33 penderita (53%) dengan kadar fibrinogen di atas harga normal (rata-rata 416,75±102,7 mg/dL). Tidak terdapat korelasi yang bermakna antara kadar fibrinogen dan HbA1c. Simpulan, tidak terdapat korelasi antara kadar fibrinogen dan HbA1c. Meskipun demikian subjek dengan diabetes melitus cenderung mempunyai kadar fibrinogen yang tinggi. [MKB. 2014;46(1):48?51]Kata kunci: Diabetes melitus tipe 2, fibrinogen, HbA1c, hypercoagulable state Hypercoagulable State and Type 2 Diabetes Mellitus: the Correlation between Fibrinogen and HbA1cHypercoagulability has been suggested as a result of type 2 diabetic mellitus vascular disease. Fibrinogen is a marker of hypercoagulability due to systemic inflammation. HbA1c level is used to measure long-term blood glucose level. There was inconsistent findings about the correlation between fibrinogen level and HbA1c. Previous study found a significant correlation between fibrinogen levels and HbA1c, while other study showed different results for this finding. The aim of this study was to determine the correlation between fibrinogen and HbA1c. A cross-sectional study was performed in outpatients type 2 diabetes mellitus (DM) in Dr. Hasan Sadikin General Hospital Bandung during January?July 2010. Patients with newly diagnosed type 2 DM, normotension, normal hemoglobin level, normal liver function test and normal kidney function test were included in this study. Fibrinogen, trigliseride, and HbA1c levels were examined. The exclusion criteria were patients taking antiplatelet drugs or oral antidiabetic and had autoimmune diseases. Spearman and regression analysis were used in this study. Sixty three subjects were included in this study. All subjects had HbA1c level more than 6.5% (mean 8.21±2.5%). Thirty three patients (53%) had fibrinogen level of more than the normal limit (mean 416.75±102.7 mg/dL). The mean of trigliseride level was 235.32±131.3 mg/dL. No significant correlation between fibrinogen and HbA1c. In conclusion, there is no correlation between the fibrinogen levels and HbA1c. However, subjects with diabetes mellitus tend to have high fibrinogen levels. [MKB. 2014;46(1):48?51]Key words: Fibrinogen, HbA1c, hypercoagulable state, type 2 diabetes mellitus DOI:  10.15395/mkb.v46n1.227
Immature Platelet Fraction in Patients with S LE-related Thrombocytopenia Tanoyo, Yeny; Rahmadi, Andri Reza; Oehadian, Amaylia
Majalah Kedokteran Sriwijaya Vol 51, No 4 (2019): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v51i4.10239

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Systemic lupus erythematosus (SLE) is an autoimmune disease which causes chronic inflammation and may impact various organs. Hematologic abnormality, including thrombocytopenia, is a common clinical manifestation in SLE, ranging between 7-30%. Thrombocytopenia in SLE has been proven to correlate with a more active disease and a worse prognosis. Most of the time, it gets hard to determine the underlying cause of thrombocytopenia. Immature platelet fraction (IPF) examines immature thrombocyte at peripheral blood and can be used to determine whether thrombocytopenia happens because of a decreased production or increased peripheral thrombocyte destruction. This study was done to evaluate immature platelet fraction value in SLE patients with thrombocytopenia. This was a cross-sectional descriptive observational study. Sample was taken from SLE inpatients and outpatients at Dr. Hasan Sadikin Bandung Hospital. There were 24 subjects included in this study, which counts 7.4% of SLE population. The mean platelet count was 56,870 ±28,933 /mm3. IPF values ranged from 0.9-3.2%, with median 5.7%. The median IPF in moderate-severe thrombocytopenia group was 7.5%, higher than that of mild thrombocytopenia group (4.2%). It can be concluded that IPF values were increased in most SLE patients with thrombocytopenia compared to normal population. It suggests that increased platelet destruction plays an important role in the pathogenesis of SLE thrombocytopenia. A wide range of IPF values shows multifactorial nature of thrombocytopenia causes in SLE patients.
COMPARATIVE RATIO OF BCR-ABL GENES WITH PCR METHOD USING THE CODIFICATION OF G6PD AND ABL GENES IN CHRONIC MYELOID LEUKEMIA PATIENTS (Perbandingan Angka Banding Gen BCR-ABL Metode PCR Menggunakan Baku Gen Glucosa-6-Phosphate Dehidrogenase dan Gen Abelson Kinase di Pasien Chronic Myeloid Leukemia) Panjaitan, Tonggo Gerdina; Prihatni, Delita; Indrati, Agnes Rengga; Oehadian, Amaylia
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 1 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i1.1186

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Chronic Myeloid Leukemia (CML) adalah keganasan hematopoetik pertama yang dihubungkan dengan jejas genetik. Chronic MyeloidLeukemia digolongkan sebagai penyakit mieloproliferatif kronis disebabkan translokasi resiprokal kromosom 9 dan 22 yang disebutkromosom Philadelphia (Ph). Kromosom Ph membentuk gen yang disebut BCR-ABL. Pemeriksaan molekuler CML bertujuan untukmengetahui aktivitas transkripsi mRNA gen BCR-ABL, yang berguna untuk menetapkan diagnosis dan pemantauan pengobatan pasienCML. Saat ini, WHO mempublikasikan ada sembilan (9) gen baku yang digunakan secara luas. Tujuan penelitian ini adalah untukmengetahui angka banding gen BCR-ABL/G6PD dan BCR-ABL/ABL di pasien CML dengan kromosom Ph (+) secara membandingkan.Penelitian ini menggunakan 79 bahan biologis tersimpan (BBT) mRNA Ph (+) dari leukosit pasien CML yang datang ke RSUPDr. Hasan Sadikin Bandung selama masa waktu antara bulan April 2012?April 2014. Pemeriksaan angka banding gen BCR-ABL/G6PDdengan metode Real-time Quantification PCR menggunakan alat LightCycler® Roche. Angka banding gen BCR-ABL/ABL diperiksamenggunakan alat Bioneer®. Gen baku G6PD dapat mendeteksi tipe b2a2, b3a2 dan e1a2. Gen baku ABL hanya dapat mendeteksi tipeb2a2 dan b3a2, tetapi lebih stabil bila dibandingkan dengan gen baku G6PD. Bentuk penelitian adalah perbandingan analitik denganrancangan kajian potong lintang. Analisis statistik menggunakan uji nonparametrik Wilcoxon. Hasil angka banding mRNA gen BCRABL/G6PD dan gen BCR-ABL/ABL [1,93% (0,0?59,7 fg) vs 15,37% (0,04?35,7 kopi), p<0,001]. Gen BCR-ABL tidak terdeteksi di 3 BBTdengan menggunakan gen baku ABL. Berdasarkan telitian ini, dapat disimpulkan, bahwa terdapat perbedaan bermakna antara angkabanding gen BCR-ABL/G6PD dan yang terkait BCR-ABL/ABL. Gen baku yang sama diperlukan untuk mendiagnosis dan memantaurespons pengobatan.