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    PP Eka Konika Hemato

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    permatamo
    1) The document examines the nutritional status of acute lymphoblastic leukemia (ALL) survivors in Manado, Indonesia. 2) A study of 45 ALL survivors found that 64% had good nutritional status, while 19% were overnourished, 6% were undernourished, and 11% were obese. 3) Statistical analysis indicated there was no significant difference in nutritional status between survivors of high-risk ALL and standard-risk ALL.

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    PP Eka Konika Hemato

    Uploaded by

    permatamo
    42 views15 pages
    1) The document examines the nutritional status of acute lymphoblastic leukemia (ALL) survivors in Manado, Indonesia. 2) A study of 45 ALL survivors found that 64% had good nutritional status, while 19% were overnourished, 6% were undernourished, and 11% were obese. 3) Statistical analysis indicated there was no significant difference in nutritional status between survivors of high-risk ALL and standard-risk ALL.

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    Pp Eka Konika Hemato

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    1) The document examines the nutritional status of acute lymphoblastic leukemia (ALL) survivors in Manado, Indonesia. 2) A study of 45 ALL survivors found that 64% had good nutritional status, while 19% were overnourished, 6% were undernourished, and 11% were obese. 3) Statistical analysis indicated there was no significant difference in nutritional status between survivors of high-risk ALL and standard-risk ALL.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    42 views15 pages

    PP Eka Konika Hemato

    Uploaded by

    permatamo
    1) The document examines the nutritional status of acute lymphoblastic leukemia (ALL) survivors in Manado, Indonesia. 2) A study of 45 ALL survivors found that 64% had good nutritional status, while 19% were overnourished, 6% were undernourished, and 11% were obese. 3) Statistical analysis indicated there was no significant difference in nutritional status between survivors of high-risk ALL and standard-risk ALL.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 15

    NUTRITIONAL STATUS

    AMONG ACUTE
    LYMPHOBLASTIC LEUKEMIA
    (ALL) SURVIVORS
    Stefanus Gunawan 1 , Eka Satria Anandita 2 , Permatami

    IN INDONESIA Herwansyah 3 , Max Mantik 4


    1
    Acute Leukemia in 30 40 % of malignancy
    children
    4 4,4 case annually /
    100,000 children below 15
    y.o
    Acute leukemia percentage is
    up to 97% of all leukemia in
    children
    82%:
    ALL
    18%:
    AML
    2
    Dr. Sardjito Hospital Dr. Soetomo Hospital
    (Yogyakarta, Indonesia) (Surabaya, Indonesia)
    1996 2002

    5-6 new cases / 79 new cases


    month during this year

    ALL: 79% ALL: 88%


    AML: 9% AML: 8%
    Chronic leukemia: Chronic leukemia:
    12% 4%
    3
    Nutritional status
    among ALL
    survivors
    Lorenzo Lughetti, Patrizia Bruzzi, Barbara Predieri,
    Paolo Paolucci
    75% of survivors have a chronic health condition
    negatively impacting on cardiovascular morbidity
    and mortality, Obesity can be considered one of
    the most important health chronic conditions in
    the general population, with an increasing
    incidence in patients treated for childhood
    cancers and especially in acute lymphoblastic
    leukemia survivors who are, at the same time,
    more at risk of experiencing precocious
    cardiovascular and metabolic co-morbidities.

    Ital J. Pediatr. 2012; 38: 4.

    Obesity
    4
    Nutritional status
    among ALL
    survivors
    Kirsten K. Ness, Saro H. Armenian, Nina Kadan-Lottick,
    James G. Gurney
    Childhood ALL survivors experience medical late
    effects that increase their risk of morbidity and
    premature death, often due to heart and vascular
    disease. Research has helped elucidate the
    mechanisms and trajectory of direct damage to
    the heart from treatment exposure, particularly to
    anthracyclines, and has also contributed
    knowledge on the influences of related chronic
    conditions, such as obesity and insulin resistance
    on heart health in these survivors.

    Expert Rev Hematol. 2011 Apr; 4(2): 185197.

    Obesity
    5
    Nutritional status
    among ALL
    survivors
    Susan J. Lindemulder, Linda C. Stork, Bruce
    Bostrom et al

    Our study of patients with SR-ALL found a


    significant increase in BMI% largely during the
    first month of therapy that is greater with
    dexamethasone than prednisone. However, after
    therapy, there was no increased risk of
    overweight/obese BMI compared to non-cancer
    peers.

    Pediatr Blood Cancer. 2015 Jun; 62(6): 10351041.

    Obesity
    6
    Cross Sectional
    study
    45 ALL 9 persons cannot be
    survivors contacted
    36 persons consented for
    examination

    National Cancer Institute


    (NCI)

    High Risk (HR) ALL : 14


    persons
    Standart Risk (SR) ALL : 22
    persons
    7
    ALL survivors weight and
    height

    WHO weight-for-height
    curve
    CDC stature-for-age and weight-for-
    age curve

    CDC body mass index curve

    Nutritional status
    8

    HR ALL

    14% 7%

    14%

    65%

    Undernourished (1 person) Good nutritional status (9 persons)


    Overnourished (2 persons) Obesity (2 persons)
    9
    ALL Standart Risk

    5%
    23%

    9%
    63%

    Undernourished (1 person) Good nutritional status (14 person)


    Overnourished (2 persons) Obesity (5 persons)
    10
    Summary of ALL survivors nutritional status

    6%
    19%

    11%

    64%

    Undernourished (2 persons) Good nutritional status (23 persons)


    Overnourished (4 persons) Obesity (7 persons)
    11
    ALL * Nutritional Status Crosstabulation
    Nutritional status
    Good
    nutritional Underno Overno
    status urished urished Obesity Total
    ALL HR ALL Count 10 1 3 2 16
    % within ALL 62.5% 6.3% 18.8% 12.5% 100.0%
    % within
    Nutritional 45.5% 50.0% 75.0% 28.6% 45.7%
    Status
    SR ALL Count 12 1 1 5 19
    % within ALL 63.2% 5.3% 5.3% 26.3% 100.0%
    % within
    Nutritional 54.5% 50.0% 25.0% 71.4% 54.3%
    status
    Total Count 22 2 4 7 35
    % within ALL 62.9% 5.7% 11.4% 20.0% 100.0%
    % within
    Nutritional 100.0% 100.0% 100.0% 100.0% 100.0%
    status
    13
    Chi-Square Tests
    Asymp. Sig. (1-
    Value df sided)
    Pearson Chi-Square 2.227a 3 .263

    N of Valid Cases 35
    a. 6 cells (75.0%) have expected count less than 5. The minimum expected
    count is .91.

    The relationship between ALL and nutritional status was tested by X 2 test.
    The test results X2 = 2.227, p = 0.263.

    These results suggest there is no difference in the distribution of


    nutritional status between HR ALL and SR ALL.
    14

    CONCLUSION

    Majority of the ALL survivors in Manado, Indonesia have


    good nutritional status. Obesity and overnutrition are not
    an issue in both SR and HR ALL survivors receiving
    chemotherapy in Manado, Indonesia.

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