Peningkatan NT-proBNP dan cTn-I Serum Pasien Limfoma Non-Hodgkin's yang Menerima Kemoterapi Berbasis Doxorubicin
DOI:
https://doi.org/10.21776/ub.jkb.2016.029.02.8Abstract
Penelitian ini bertujuan menilai perubahan kadar cTn-I dan NT-proBNP serum pasien Limfoma Non-Hodgkin's (LNH) yang dikemoterapi berbasis doxorubicin (DOX). Penelitian menggunakan desain prospective cohort observational dengan kriteria inklusi yaitu pasien LNH usia 16 s/d 65 tahun, ECOG scale ≤2, serum kreatinin ≤1,5mg/dl, dan fungsi liver normal. Kriteria eksklusi antara lain memiliki PJK, penyakit katup jantung dengan gangguan hemodinamik, ekokardiografi prekemoterapi LVEF <50%, sedang atau riwayat iradiasi di dinding thorax. Sampel darah diambil sebelum dan 24 jam setelah kemoterapi. Dari 34 pasien yang diteliti, lansia 20 pasien, dewasa 13 pasien dan 1 pasien remaja. Sebanyak 33 pasien dengan skor ECOG 1. Kadar cTn-I 23 pasien meningkat 24 jam pascakemoterapi ke-1 dan berbeda bermakna jika dibandingkan kadar cTn-I prekemoterapi (p<0,001). Kadar NT-proBNP 11 pasien meningkat 24 jam pascakemoterapi ke-1 dan 22 pasien meningkat 24 jam pascakemoterapi ke-2. Kadar NT-proBNP pascakemoterapi ke-1 berbeda bermakna jika dibandingkan prekemoterapi (p<0,001). Kadar NT-proBNP pascakemoterapi ke-2 berbeda bermakna jika dibandingkan prekemoterapi (p<0,001). Kadar NT-proBNP dosis DOX 100mg/m2 LPT berbeda bermakna jika dibandingkan dosis 50mg/m2 LPT (p=0,001). Uji regresi logistik menunjukkan usia tua berhubungan dengan risiko peningkatan NT-proBNP (RR=6,271 (CI:1,295, 30,382), p=0,023). Kesimpulannya, terdapat peningkatan kadar cTn-I dan NT-proBNP pada pasien LNH setelah kemoterapi berbasis DOX.
Kata Kunci: Doxorubicin, cTn-I, Limfoma Non-Hodgkin's, NT-proBNP
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