Obesitas Sebagai Faktor Prognosis Buruk pada Anak dengan Leukemia Limfoblastik Akut

  • Giovanni Reynaldo
  • Bernadina Cynthia Carsantiningrum
  • Yurika Elizabeth Susanti

Abstract

Tinjauan pustaka ini bertujuan untuk memberikan paparan mengenai faktor-faktor yang memengaruhi hasil akhir leukemia limfoblastik akut (LLA) pada anak. LLA merupakan jenis kanker yang paling umum terjadi pada anak dan merupakan penyebab kematian akibat kanker terbanyak pada usia di bawah 20 tahun. Salah satu masalah kronis yang perlu diperhatikan secara serius terutama dalam kasus LLA adalah obesitas. Beberapa mekanisme dianggap berperan dalam kaitan antara LLA dengan obesitas. Salah satunya adalah meningkatnya hormon endogen (hormon seks steroid, insulin dan insulin growth factor-1) akibat akumulasi lemak tubuh yang berperan penting dalam mengontrol pertumbuhan, diferensiasi, dan metabolisme sel. Inflamasi kronik juga berperan dalam timbulnya sel kanker. Sel adiposit merupakan sumber poten untuk timbulnya sitokin inflamasi. Prognosis buruk pada pasien anak dengan obesitas berkaitan dengan beberapa faktor seperti dosis terapi yang tidak adekuat, usia dibawah 1 tahun atau di atas 10 tahun pada saat diagnosis, dan hitung leukosit di atas 50.000/mm3.

References

1. Hunger SP, Mulighan CG. Acute lymphoblastic leukemia in children. N Engl J Med. 2015;373(16):1541-52. doi: 10.1056/nejmra1400972
2. Lustosa de Sousa DW, De Almeida Ferreira FV, Cavalcante Fèlix FH, Oliveira MV. Acute lymphoblastic leukemia in children and adolescents: Prognostic factors and analysis of survival. Rev Bras Hematol Hemoter. 2015;37(4):223-9. doi: 10.1016/j.bjhh.2015.03.009
3. Larsson SC, Wolk A. Overweight and obesity and incidence of leukemia: a Meta-analysis of cohort studies. Int J Cancer. 2008;122:1418-21.
4. Gelelete CB, Pereira SH, Azevedo AMB, Thiago LS, et al. Overweight as a prognostic factor in children with acute lymphoblastic leukemia. Obesity. 2011;19:1908-1911. doi: 10.1038/oby.2011.195
5. Sari TT, Windiastuti E, Cempako GR, Devaera Y. Prognosis leukemia limfoblastik akut pada anak obes. Sari Pediatri. 2010;12(1):58-62.
6. Ntziachristos P. iAMPlified gene expression offers new insights in B cell precursor leukemia subtype. Leukemia & Lymphoma. 2020:1-3. doi: 10.1080/10428194.2019.1695055
7. Lim JY, Bhatia S, Robinson LL, Yang JJ. Genomics of racial and ethnic disparities in childhood acute lymphoblastic leukemia. Cancer. 2014;120:955-62.
8. Buitenkamp TD, Izraeli S, Zimmermann M, et al. Acute lymphoblastic leukemia in children with down syndrome: A retrospective analysis from the ponte di legno study group. Blood. 2014;123:70-7.
9. Perez-Andreu V, Roberts KG, Harvey RC, et al. Inherited GATA3 variants are associated with ph-like childhood acute lymphoblastic leukemia and risk of relapse. Nat Genet. 2013;45:1494-8.
10. Pernomo B, Sutaryo, Ugrasena I, Windiastuti E, Abdulsalam M. Buku ajar hematologi-onkologi anak. 2nd ed. Jakarta: Ikatan Dokter Anak Indonesia; 2006. 242–4.
11. Cooper SL, Brown PA. Treatment of pediatric acute lymphoblastic leukemia. Pediatr Clin North Am. 2015;62(1):61–73.
12. Yakin R, Syarif S, Tehuteru ES. Perbandingan kesintasan tiga tahun pada anak leukemia limfoblastik akut antara protokol pengobatan 2006 dan 2013. Indonesian Journal of Cancer. 2017;6;11(3):111–7.
13. National Cancer Institute. Childhood acute lymphoblastic leukemia treatment (PDQ®)–health professional version [Internet]. National Cancer Institute. 2020 [cited 2020 Mar 2]. Available from: https://www.cancer.gov/types/leukemia/hp/child-all-treatment-pdq#_727
14. National Comprehensive Cancer Network. Acute lymphoblastic leukemia [Internet]. NCCN guidelines for patients. 2019 [cited 2020 Mar 2]. Available from: https://www.nccn.org/patients/guidelines/content/pdf/all-patient.pdf
15. Butturini AM, Dorey FJ, Lange BJ, Henry DW, Gaynon PS, et al. Obesity and outcome in pediatric acute lymphoblastic leukemia. Journal of Clinical Oncology. 2007;25(15):2063-8. Doi: 10.1200/JCO.2006.07.7792
16. Hong K, Yan E, Chen S, Li Z, Heber D. Obesity and Cancer: Inflammation and molecular pathogenesis. Obesity Manag. 2007;3:115-20.
17. Butturini A, Dorey F, Gaynon P, Fu C, Franklin J, Siegel S, et al. Obesity and body weight independently predict relapse and survival in preadolescents and teenagers with acute lymphoblastic leukemia (ALL): A Retrospective analysis of five children cancer group (CCG) studies. Blood (ASH Annual Meeting Abstracts).2004;104:Abstract 992.
18. Hunger SP, Lu X, Devidas M, Camitta BM, Gaynon P, Winick NJ, et al. Improved survival for children and adolescents with acute lymphoblastic leukemia between 1990-2005: A report from the children’s oncology group. 2012;30(4):1663-8. Doi:10.1200/JCO.2011.37.8018
19. Cheymol G. Effects of obesity on pharmacokinetics implication for drug therapy. Clin Pharmacokinet. 2000;39:215-31.
20. Baillargeon J, Langevin AM, Lewis M, Thomas PJ, Mullins J, Dugan J, et al. L-asparginase as a marker of chemotherapy dose modification in children with acute lymphoblastic leukemia. Cancer. 2005;104:2858-61.
21. McMillan DC, Sattar N, Lean M, McArdle CS. Obesity and cancer. BMJ. 2006;333:1109-11.
22. Barb D, Williams CJ, Neuwirth AK, Mantzoros CS. Adiponectin in relation to malignancies: A review of existing basic research and clinic swal evidence. Am J Clin Nutr. 2007;86:858S-66S.
23. Lee JW, Cho B. Prognostic factors and treatment of pediatric acute lymphoblastic leukemia. Korean J Pediatr. 2017;60(5):129-37. doi: 10.3345/kjp.2017.60.5.129
24. Pieters R, Schrappe M, De Lorenzo P, Hann I, De Rossi G, Felice M, et al. A Treatment protocol for infants younger than 1 year with acute lymphoblastic leukemia (Interfant-99): an observational study and a multicentre randomised trial. Lancet. 2007;370:240-50.
25. Smith M, Arthur D, Camitta B, Carroll AJ, Crist W, Gaynon P, et al. Uniform approach to risk classification and treatment assignment for children with acute lymphoblastic leukemia. J Clin Oncol. 1996;14:18-24.
26. Moricke A, Zimmermann M, Reiter A, Henze G, Schrauder A, Gadner H, et al. Long term results of five consecutive trials in childhood acute lymphoblastic leukemia performed by the ALL-BFM study group from 1981-2000. Leukemia. 2010;24:265-84.
Published
2020-06-30
How to Cite
Reynaldo, G., Carsantiningrum, B., & Susanti, Y. (2020). Obesitas Sebagai Faktor Prognosis Buruk pada Anak dengan Leukemia Limfoblastik Akut. Jurnal Kedokteran Meditek, 26(2), 43-49. https://doi.org/10.36452/jkdoktmeditek.v26i2.1828
Section
Tinjauan Pustaka