Objective. This study aims to identify predictors of 72-hour mortality in patients with diabetic ketoacidosis (DKA).Methodology. In this retrospective cohort study, data were obtained from medical records of adult patients with DKA in Cipto Mangunkusumo General Hospital from January 2011 to June 2017. Associations of predictors (age, type of diabetes, history of DKA, comorbidities, level of consciousness, renal function, bicarbonate, potassium, lactate, betahydroxybutyrate levels, and anion gap status) and 72-hour mortality were analyzed. The mortality prediction model was formulated by dividing the coefficient B by the standard error for all variables with p<0.05 in the multivariate analysis.Results. Eighty-six of 301 patients did not survive 72 hours after hospital admission. Comorbidities (HR 2.407; 95% CI 1.181-4.907), level of consciousness (HR 10.345; 95% CI 4.860-22.019), history of DKA (HR 2.126; 95% CI 1.308-3.457), and lactate level (HR 5.585; 95% CI 2.966-10.519) were significant predictors from multivariate analysis and were submitted to the prediction model. The prediction model had good performance. Patients with total score less than 3 points were at 15.41 % risk of mortality, 3 -4 points were 78.01% and 5 -6 points were 98.22% risk of mortality. Conclusion.The 72-hour mortality rate in Cipto Mangunkusumo General Hospital was 28.57%. The mortality prediction model had a good performance and consisted of comorbidities, history of DKA, level of consciousness and lactate level.

121 Background: Chronic lymphocytic leukemia (CLL) was a common hematological malignancy in America and Europe, but rarely found in Asia. Differences in clinical characteristics and treatment response were suspected. This study aimed to find out characteristics and treatment response of patient with CLL in Dharmais National Cancer Centre Hospital Indonesia. Methods: This was a retrospective cohort study of CLL patients in Dharmais Hospital during 2013-2015. Data were retrieved from medical record included patients’ demography, blood examination, bone marrow puncture, and immunophenotyping. Prognosis factors such as Rai and Binet staging system were studied. Results: A total of 36 CLL patients were retrieved. Most of patients (58.3%) were male. Median age was 58.5 years old. As much as 25.9% of patients were asymptomatic. There were 17 patients (47.2%) with negative CD5, and most of them (63.2%) had isolated splenomegaly (p = 0.019). Twenty patients (55.6%) were high-risk based on Rai staging group, but there were only 14 patients (38.9%) were high-risk based on Binet staging group. Positive CD13 was found in 30.6% patients and classified as high risk Rai (p < 0.001) and Binet (p = 0.043) staging group. Treatment response was available in 12 cases, consisted of 8 (66.7%) partial responses, 3 (25.0%) progressive diseases, and 1 (8.3%) stable disease. Conclusions: Chronic lymphocytic leukemia is a rare disease in Indonesia. Patients tend to be younger and have worse prognosis. Many cases are categorized as high-risk and present without specific clinical symptoms. Early detection is challenging in the future for better management of CLL cases.

Aim: To compare between entecavir and lamivudine as hepatitis B reactivation prophylaxis in cancer patient with chemotherapyMethod could evoke its resistance lead to a question about how effective entecavir as a drug of choice in Indonesia for HBV reactivation prophylaxis in chemotherapy patients. This is the reason why this topic were discussed in this evidence-based case report.

Introduction: Observational studies evaluating the association between long-acting insulins and breast cancer incidence is limited. We conducted a systematic review to compare the incidence of breast cancer between diabetes mellitus (DM) patients on longacting insulin treatment. Methodology: We systematically searched the literatures from MEDLINE, Science Direct and PROQUEST from 2008 to 2018 to identify all observational studies evaluating the relationship between use of insulin glargine and human Neutral Protamine Hagedorn (NPH) insulin to breast cancer incidence among patients with type-1 and/or type-2 diabetes mellitus (DM) aged ≥ 18 years old. The methodological aspects such as residual confounding and duration of follow-up were assessed. Results: A total of four cohort studies met our inclusion criteria. Follow-up duration ranged from 0.9 to 3.3 years. Two studies showed, the use of insulin glargine was associated with an increased risk of breast cancer in comparison with human NPH insulin and two other studies found no evidence of breast cancer. All of these studies had a short follow-up duration and were not able to examine residual confounding. Conclusion: We found limited support for association of glargine use with increased breast cancer risk compared to human NPH insulin due to the methodological issues. Further studies with better methodological aspects are needed to explain the difference of breast cancer incidence between those treatments.