Human immunodeficiency virus (HIV) is a virus from the Retrovirus family that attacks human immune cells, especially T lymphocytes. The increasing number of HIV cases requires a more effective preventive measure; among others is through vaccination. Although it has been about 40 years, there is no HIV vaccine on the market yet. It can be because of many variations of HIV and each country has its own dominant HIV variant. In addition, the ability of HIV virus to evade immune responses, high mutation rates, and limited experimental animals add to the difficulties to develop effective vaccines. As of May 2022, 16 vaccines are currently undergoing phase I/II clinical trials. Among HIV vaccines that have already undergone phase III clinical trials, only RV 144 vaccine gave promising results, with efficacy reaching 31.2%. The development of the HIV vaccine continues to obtain a safe and effective HIV vaccine. Human immunodeficiency virus (HIV) merupakan virus dari famili Retrovirus yang menyerang sel imun manusia terutama limfosit T. Kasus infeksi HIV yang terus meningkat, membutuhkan tindakan pencegahan yang lebih efektif antara lain dengan vaksin HIV. Tetapi, meskipun sudah sekitar 40 tahun, belum ada vaksin HIV yang diedarkan. Hal ini bisa karena banyaknya variasi HIV serta tiap negara memiliki varian HIV dominan yang berbeda. Selain itu, kemampuan HIV menghindari respon imun, laju mutasi yang tinggi, ditambah dengan keterbatasan hewan coba, menyulitkan pembuatan vaksin. Hingga bulan Mei 2022 terdapat 16 vaksin yang tengah menjalani uji klinis fase I/II. Di antara vaksin HIV yang sudah pernah menjalani uji klinis fase III, hanya vaksin RV 144 yang memberikan hasil menjanjikan yakni efikasi mencapai 31,2%. Perkembangan vaksin HIV terus berlanjut untuk mendapatkan vaksin HIV yang aman dan efektif.
Background: Glucocorticoid corticosteroids have vasoconstrictive, anti-proliferation, anti-inflammatory, and immunosuppressant effects through interactions with glucocorticoid receptors which have also been found in one type of leukemia, acute lymphoblastic leukemia (ALL). The most common side effect long-term use of high dose corticosteroids is increase in body weight resulting in obesity. It is one of the main problems in ALL patients, because it leads to persistent leukemia, increase of the risk of recurrence, and poor event-free survival. This has been associated with the use of glucocorticoids namely dexamethasone and prednisone in the induction phase chemotherapy process. Objectives: This study was intended to determine the association of corticosteroid administration to weight gain in children with ALL induction phase. Methods: The study was analytic-cross sectional. A total of 62 medical records of pediatric patients with ALL in Haji Adam Malik General Hospital Medan in 2015-2018. The data obtained were processed using the Wilcoxon statistical test, the Mann-Whitney test, and the Spearman-Correlation Rank test. Results: Wilcoxon test showed the effect of corticosteroid administration on body weight in the sample (p = 0.001). The Mann-Whitney test showed a difference in the influence of the use of prednisone and dexamethasone on sample body weight (p = 0.001), but it was not found regarding the nutritional status of the sample (p = 0.149). The Spearman-correlation test showed that there was no association of weight gain with the total corticosteroid dose given (p = 0.251). Conclusion: There is an association of corticosteroid administration to body weight in children with ALL induction phase. There are differences in the influence of the use of prednisone and dexamethasone on body weight, while there is no such difference on nutritional status in children with ALL induction phase. There is no association of weight gain based on the total corticosteroid dose given during the induction phase in children with ALL. Keywords: acute lymphoblastic leukemia, corticosteroid, induction phase chemotherapy, weight gain Latar Belakang: Kortikosteroid golongan glukokortikoid memiliki efek vasokontriksi, anti-proliferasi, anti-inflamasi, dan imunosupresan melalui interaksinya dengan glucocorticoid receptor yang juga telah ditemukan pada salah satu jenis leukemia yaitu leukemia limfoblastik akut (LLA). Efek samping paling sering dari penggunaan kortikosteroid jangka panjang dengan dosis tinggi adalah peningkatan berat badan berlebih yang berakibat pada obesitas. Hal ini menjadi salah satu masalah utama pada pasien LLA, karena dapat menyebabkan leukemia persisten, meningkatkan risiko kekambuhan, dan event-free survival yang buruk. Hal tersebut telah dikaitkan dengan penggunaan glukokortikoid deksametason dan prednisone dalam proses kemoterapi LLA fase induksi. Tujuan: Penelitian ini dimaksudkan untuk mengetahui hubungan pemberian kortikosteroid terhadap kenaikan berat badan pada anak penderita leukemia limfoblastik akut fase induksi. Metode: Penelitian yang dilakukan bersifat analitik-cross sectional. Dikumpulkan sebanyak 62 rekam medis pasien anak penderita LLA di RSUP Haji Adam Malik Medan tahun 2015-2018. Data yang diperoleh diolah menggunakan uji statistik Wilcoxon, uji Mann-Whitney, dan uji Rank Spearman-Correlation. Hasil: Uji Wilcoxon menunjukkan adanya pengaruh pemberian kortikosteroid terhadap berat badan pada sampel (p = 0,001). Uji Mann-Whitney menunjukkan adanya perbedaan pengaruh penggunaan prednison dan deksametason terhadap berat badan sampel (p = 0,001), tetapi tidak terhadap status gizi sampel (p = 0,149). Uji Rank Spearman-Correlation menunjukkan tidak terdapat hubungan kenaikan berat badan terhadap total dosis kortikosteroid yang diberikan (p = 0,251). Kesimpulan: Terdapat hubungan pemberian kortikosteroid terhadap berat badan anak penderita LLA fase induksi. Terdapat perbedaan pengaruh penggunaan prednison dan deksametason terhadap berat badan anak penderita LLA fase induksi, tetapi tidak terhadap status gizi. Tidak terdapat hubungan kenaikan berat badan berdasarkan total dosis kortikosteroid yang diberikan selama fase induksi pada anak penderita LLA. Kata kunci: kemoterapi fase induksi, kenaikan berat badan, kortikosteroid, leukemia limfoblastik akut
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.