IDENTIFICATION OF FACTORS RELATED TO HEMATOTOXICITY, HEPATOTOXICITY, AND NEPHROTOXICITY IN THE INDUCTION PHASE OF ACUTE LYMFOBLASTIC LEUKEMIA AT DR. HASAN SADIKIN BANDUNG 2020-2023

• Main Author: Khatami Maulana, Fathi
• Format: Final Project
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/74231
• Institution: Institut Teknologi Bandung

Cases of Acute Lymphoblastic Leukemia (ALL) in children account for around 70% of all cancer cases in Indonesia. The primary treatment for ALL in children involves chemotherapy with more complex regimens. Complex therapeutic regimens are one of the important factors that contribute to the occurrence of adverse drug effects (ADRs). Drug toxicity is defined as the various ADRs arising from drug use, both at therapeutic and non-therapeutic doses. This study aims to assess the severity of ADRs based on CTCAE v.5 and determine the relationship between patient demographic characteristics and drug toxicity in the induction phase. The study was conducted using an observational cohort methodology, and data were collected retrospectively from (02/01/2020) to (17/02/2023). The source of demographic data was obtained from electronic medical records, and data on drug toxicity was analyzed based on the patient's laboratory test results. The results of the study using bivariate analysis showed significant differences between gender and ADR anemia, age, and decreased neutrophil count, risk stratification and decreased neutrophil count, as well as BMI and increased ALT serum levels (p=0.049; p=0.004; p = 0.037; p = 0.022). Meanwhile, multivariate analysis revealed a significant difference between age and decreased neutrophil count (OR = 0.85; 95% CI 0.75–0.96; p = 0.011), age and decreased platelet count (OR = 0.89; 95% CI 0.81-0.99; p = 0.049), and BMI and increased serum ALT levels (OR = 0.43; 95% CI 0.2-0.92; p = 0.029). In conclusion, the most frequently observed ADRs were decreased neutrophil counts (67.95%), decreased platelet counts (59.52%), and anemia (30.59%). Demographic and clinical factors are associated with the occurrence of drug toxicity.