Article Sidebar

Submitted
5 April 2018
Accepted
5 April 2018
Published
5 April 2018
Download
PDF
Statistic
Read Counter : 3498 Download : 1754

Main Article Content

Abstract

Prednisone has an important role in the therapy of patient with standard risk ALL. Patients with standard risk ALL receiving high dose prednisone as therapy and supraphysiology dose of prednisone are expected to cause suppression in HPA-axis (Hypothalamic Pituitary Adrenal axis). This suppression could reduce immune system in children with ALL and increase infection risk because reduction of cortisol level. In Indonesia, we did not find study about the incident of adrenal suppression after high dose prednisone therapy, especially in induction to consolidation phase ALL patient. The aim of this study was to analyze adrenal suppression after high dose prednisone therapy on children with standard risk acute lymphoblastic leukemia in induction and consolidation phase. This study has received a certificate of Ethical Clearance No. 588/Panke.KKE/X/2016, a longitudinal observational, prospective, non-randomized trial involving children with ALL who received prednisone for 49 days during the induction phase. We collected and compared laboratory result of cortisol level in children with ALL and received prednisone therapy during induction to consolidation phase. Sample was taken at week 0,4,5,6,7,8,10,12 in the course of ALL chemotheraphy Indonesian protocol year 2013. Serum was examined using methods CLIA ADVIA Centaur® XP. Between June 2016 – January 2017, 13 patients (8 males, 5 females) were included in this study. Decrease of cortisol level after prednisone therapy occured in week-10 as much as 53% compared with week-0  (p=0.027). Cortisol level increased 64% of week-12 compared with week-10 (p=0.003). In conclusion, high dose prednisone is not significant to causing adrenal suppression in induction phase of ALL patients, and the reducing cortisol level is reversible.

Keywords

Standard risk acute lymphoblastic leukemia cortisol levels adrenal suppression prednisone induction phase chemotherapy consolidation phase chemotherapy

Article Details

License

  • Folia Medica Indonesiana is a scientific peer-reviewed article which freely available to be accessed, downloaded, and used for research purposes. Folia Medica Indonesiana (p-ISSN: 2541-1012; e-ISSN: 2528-2018) is licensed under a Creative Commons Attribution 4.0 International License. Manuscripts submitted to Folia Medica Indonesiana are published under the terms of the Creative Commons License. The terms of the license are:

    Attribution ” You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

    NonCommercial ” You may not use the material for commercial purposes.

    ShareAlike ” If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.

    No additional restrictions ” You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

    You  are free to :

    Share ” copy and redistribute the material in any medium or format.

    Adapt ” remix, transform, and build upon the material.

How to Cite
Amarullah, A., Hasmono, D., Ugrasena, I., & Yulistiani, Y. (2018). Children with Standard Risk Acute Lymphoblastic Leukemia in Induction And Consolidation Phase. Folia Medica Indonesiana, 54(1), 59–63. https://doi.org/10.20473/fmi.v54i1.8054
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Ahmet A, Kim H, Spier S (2011). Adrenal suppression: a practical guide to the screening and management of this under-recognized complication of inhaled cortico-steroid therapy. Allergy, Asthma & Clinical Immu-nology 7, 1-12
  2. Ansari S, et al (2014). Suppression of adrenal axis function after high-dose steroid therapy for childhood acute lympoblastic leukemia in Iran. International Journal of Contemporary Pediatrics 1, 164-167
  3. Christensen MS, et al (2005). Treatment-related death in childhood acute lymphoblastic leukaemia in the Nordic Countries: 1992-2001. British Journal of Hae-matology, 50-58
  4. Chrousos GP, Katzung BG, Trevor AJ (2014). Adreno-corticosteroids & adrenocortical antagonists in: Katzung basic & clinical pharmacology. 13th Eds. New York: McGraw-Hill Education.
  5. Conter V, et al (2009). Long-term result of the Italian Association of Pediatric Hematology and Oncology (AIEOP) Studies 82, 87, 88, 91 and 95 for childhood acute lymphoblastic leukemia. Leukemia 24, 255-264
  6. Einaudi S, Bertorello N, Masera N, Farinasso L, Barisone E, et al (2008). Adrenal axis function after high-dose steroid therapy for childhood acute lympho-blastic leukemia. Pediatric Blood Cancer 50, 537-41
  7. Gupta P, Bhatia V (2008). Corticosteroid physiology and principles of therapy. Indian J Pediatr 75, 1039-1044
  8. Hochberg Z, et al (2003). Endocrine withdrawal syndro-mes. Endocrine Reviews 24, 523-538
  9. Jabbour EJ, Faderi S, Kantarjian HM (2005). Adult acute lymphoblastic leukemia symposium on onco-logy practice: hematological malignancies. Mayo Clin Proceeding 80, 1517-1527
  10. Lanzkowski P (2011). Leukemias in manual of pediatric hematology and oncology. 5th ed. United Stated: Academic Press, p 518-525
  11. Longui CA (2007). Glucocorticoid therapy: minimizing side effects. J Pediatr 83, S163-171
  12. Pui C (2000). Acute lymphoblastic leukemia in child-ren. Leukemia. Current Opinion in Oncology 12, 3-12
  13. Pulungan A, et al (2010). Korteks adrenal dan ganggu-annya. Buku ajar endokrinologi anak. Jakarta, Badan Penerbit IDAI, p 251-293
  14. Prucker C, et al (2009). Induction death and treatment-related mortality in first remission of children with acute lymphoblastic leukemia: a population-based analysis of The Austrian Berlin-Frankfurt-Munster study group. Leukemia. UK, Macmillan Publishers Ltd
  15. Shulman D, Palmert M, Kemp S (2007). Adrenal insufficiency: still a cause of morbidity and death in childhood. Pediatrics 199, 484-94
  16. Silverman LB, et al (2000). Result of dana-farber cancer institute consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1981-1995). Leukemia. UK, Macmillan Publishers Ltd
  17. Ward E, et al (2014). Childhood and adolescent cancer statistics. A Cancer Journal for Clinicians 64, 83-103

Most read articles by the same author(s)

1 2 3 > >>