Aim: To assess CML patient's characteristic including demographic, clinical and hematological characteristic of patients with CML including quantitative BCR-ABL and BCR-ABL gene sequencing. Methods: This study was an open-label, single arm, non-randomized, cross sectional study in patients with CML being treated with imatinib mesylate (IM) from 12 centers. Result: A total of 100 patients were evaluated between January 1, 2009 and December 31, 2011. The median age was 34-35 years old (mean of age is 36 years old), and more patients in the productive age was found.-(?) were 80 of the 100 patients who had been examined for the BCR-ABL gene mutation with the sequencing method before consuming IM. Mutation in the P-loop was seen in 2,27% (1 out of 44 patients), this finding was beyond our expectation since 47,69% (31 out of 65 patients) of our patients did not achieved CHR at three months. On the other hand, 15,9% (7 out of 44 patients) of our patients had mutation outside the P-loop. Conclusions: The characteristics of CML patients in Indonesia were not different from CML patients in Asia in general. Our finding concerning the high frequency mutation in the BCR-ABL gene outside the P-loop needs further study.

A case of male, 34 years old with a diagnosis of immunodeficiency syndrome resulting from HIV infection with suspected pneumonia in the differential diagnosis of pulmonary tuberculosis relapse, in the course of the disease, patients experienced hypersensitivity reactions to some antibiotics and antituberculosis drugs. Hypersensitivity reactions were exaggerated by immune response to an allergen in a normal immune system. In this case, we found the drug hypersensitivity reactions in patients with immunodeficiency. Until now, the exact underlying mechanism is not fully known but may be due to multifactorial and the dysregulation of the immune system due to HIV infection.

Objective: Hypoxia-associated biomarkers profiling may provide information for prognosis, staging, and subsequent therapy. We aim to evaluate whether the quantitative gene and protein expression of hypoxic response tumor markers-carbonic anhydrase IX (CAIX) and hypoxia-inducible factor 1 alpha (HIF1A)-may have a role in predicting survival in advanced breast cancer of Indonesian population. Methods: Tumor tissues and peripheral blood samples were collected from treatment-naïve locally advanced (LABC) or metastatic breast cancer patients (MBC) at Wahidin Sudirohusodo General Hospital (Makassar, South Sulawesi) and its referral network hospitals from July 2017 to March 2019. The level of mRNA (of blood and tumor tissue samples) and soluble protein (of blood samples) of CAIX and HIF1A were measured by RT-qPCR and ELISA methods, respectively, besides the standard histopathological grading and molecular subtype assessment. The CAIX and HIF1A expression, patients' age, tumor characteristics, surgery status, and neoadjuvant chemotherapy drug classes were further involved in survival analyses for overall survival (OS) and progression-free survival (PFS). Results: Forty (30 LABC, 10 MBC) eligible patients examined were 21 hormone-receptors positives (15 Luminal A, 6 Luminal B) and 19 hormone-receptors negatives (10 HER2-enriched, 9 triple-negative). The CAIX blood mRNA and CAIX soluble protein levels in hormone-receptors negative patients were higher than in hormone-receptor-positive patients (p < 0.05). In univariate analysis, both CAIX and HIF1A levels predict OS (except HIF1A protein) with CAIX tissue mRNA has the highest hazard ratio (HR 8.04, 95%CI:2.45-26.39), but not PFS. Cox proportional hazard model confirmed that CAIX tissue mRNA is the independent predictor of OS (HR 6.10, 95%CI: 1.16-32.13) along with surgical status and tumor advancement type (LABC or MBC). Conclusions: CAIX mRNA expression of tumor tissue in treatment-naïve advanced breast cancer has a predictive value for OS.

BACKGROUND/AIM: Venous thromboembolism (VTE) occur from formation of blood clots in the veins, which are mostly composed of fibrin and red blood cells with a small component of leukocytes and platelets. Most VTE manifests as deep vein thrombosis (DVT) and pulmonary embolism (PE). The lack of availability of Doppler ultrasound in health facilities especially in remote areas, makes the diagnosis of DVT challenging. There for, history taking, physical examination and laboratory findings are very important in diagnosing DVT especially in those area where Doppler ultrasound unavailable. Based on this we study the correlation Wells scores, Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Fibrinogen, and D-Dimer levels with the findings on Doppler ultrasound in patients with suspected DVT in Wahidin Sudirohusodo Hospital Makassar. METHOD: The study was conducted in Department of Internal Medicine, Wahidin Sudirohusodo Hospital Makassar from 2018 to 2019. Subjects were inpatients in Department of Internal Medicine with DVT suspicion. Wells scores, PT, APTT, Fibrinogen, D-Dimer levels and Doppler ultrasound results of all subjects were recorded and then analyzed. The patient is DVT positive if confirmed by Doppler Ultrasonography. Statistical analysis was performed by descriptive statistical calculations and frequency distribution as well as the Independent-t statistical test, Chi Square test and Fisher Exact test. RESULTS: Among 38 subject, 24 were men (63.2%) and 14 were women (36.8%). We found higher Wells score, shortened PT and APTT, increased fibrinogen in subject with positive Doppler ultrasound, without a significant correlation. A significant correlation was found between increased D-Dimer levels positive Doppler ultrasound results (79.4%, p = 0.048). When Wells score is added with analysis a significant correlation was also found (80.6%, p = 0.044). CONCLUSION: A significant correlation was found between increased D-Dimer levels positive Doppler ultrasound results (79.4%, p = 0.048). When Wells score is added with analysis a significant correlation was also found (80.6%, p = 0.044).

Objective The present study evaluated the profile of endoglin (CD105) and vascular endothelial growth factor (VEGF) based on staging and histopathological grading of colorectal cancer as well as their relationship with bevacizumab therapy. Methods A total of 88 cases of colorectal adenocarcinoma were included in the present study. The levels of VEGF and CD105 protein were evaluated with enzyme-linked immunosorbent assay (ELISA). Results There was a significant difference in the level of CD105 (p = 0.002) between metastases and non-metastases subjects, showing that CD105 was higher in metastases subjects (4.59 ng/ml). There was no significant difference in the level of VEGF based on the presence of metastasis (p = 0.625). There was a significant difference in the levels of CD105 (p = 0.038) and VEGF (p = 0.010) between the subjects who received chemotherapy and those who did not. The CD105 level was higher in the subjects who received chemotherapy (4.43 ng/ml); conversely, the level of VEGF was lower in subjects who received chemotherapy (543.65 pg/ml). There was a statistically significant difference in the levels of CD105 (p = 0.003) and VEGF (p = 0.002) between subjects who received bevacizumab therapy and subjects who did not. The levels of CD105 were higher in subjects who received bevacizumab therapy (5.11 ng/ml); in contrast, the level of VEGF was higher in subjects who did not receive bevacizumab therapy (645.92 pg/ml). There was a significant positive correlation between CD105 and VEGF in subjects who did not receive bevacizumab (p < 0.01). Conclusion The results of this study support a hypothesis of “escape mechanism” in the failure of anti-angiogenesis therapy (anti-VEGF).