Tesis

Profil Kesintasan dan Respons Terapi Pasien Usia Lanjut dengan Limfoma Non-Hodgkin yang Menjalani Kemoterapi = The Profiles of Survival and Response Rate of Elderly Patients with Non-Hodgkin's Lymphoma Undergoing Chemotherapy.

Latar Belakang. Insidens Limfoma Non-Hodgkin (LNH) meningkat pada populasi usia lanjut. Kemoterapi merupakan modalitas utama terapi LNH. Profil kesintasan dan respons terapi pasien usia lanjut dengan LNH yang menjalani kemoterapi belum diketahui di Indonesia. Tujuan. Mengetahui profil kesintasan 1 tahun dan respons terapi pasien usia lanjut dengan LNH yang menjalani kemoterapi di Indonesia. Metode. Penelitian deskriptif ini dilakukan secara kohort retrospektif di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo. Sampel diambil secara total sampling dari rekam medik bulan Januari 2017 – Desember 2019. Melalui telaah rekam medik, data pasien yang dikumpulkan berupa demografi subjek, profil kesintasan 1 tahun, skrining gizi, status kemandirian, komorbiditas, laboratorium, patologi anatomi, gejala toksisitas, dan respons terapi. Hasil. Dari 78 subjek, didapatkan hasil mayoritas kelompok usia 60-69 tahun (74,35%; n=58), median usia 66 tahun (rentang 60-91; SB 5,91), berjenis kelamin laki-laki (61,54%; n=48), kesintasan 1 tahun 58,7%. 17 subjek hanya dihitung persentase kelompok jenis kelamin, usia, dan dicatat angka kesintasannya dari electronic medical record karena tidak didapatkan data rekam medis, 61 subjek dapat ditelaah keseluruhan datanya. Dari 61 subjek didapatkan mayoritas subjek berisiko malnutrisi sebelum menjalani kemoterapi (80,33%; n=49), termasuk kategori pasien mandiri sebelum menjalani kemoterapi (55,74%; n=34), komorbiditas terbanyak hipertensi (54,10%; n=33), memiliki multikomorbid (34,43%; n=21), memiliki kadar Hb ≤ 11 sebelum menjalani kemoterapi (42,62%), merupakan tipe LNH agresif (65,57%; n=40), mengalami toksisitas sistem gastroenterologi (68,85%; n=42) dan hematologi (63,93%; n=39), mengalami respons komplit setelah 6 siklus kemoterapi (34,43%; n=21). Kesimpulan. Mayoritas pasien usia lanjut dengan LNH yang menjalani kemoterapi lini pertama di Indonesia memiliki profil median usia 66 tahun, berjenis kelamin laki-laki, merupakan tipe LNH agresif, berisiko mengalami malnutrisi, termasuk kategori yang mandiri, memiliki multikomorbid dengan komorbiditas terbanyak adalah hipertensi, mengalami anemia, kesintasan 1 tahun 58,7%, dan mengalami toksisitas gastroenterologi dan hematologi.
Kata kunci. Limfoma Non-Hogkin, usia lanjut, kemoterapi, kesintasan, respons terapi.


Background. The incidence of Non-Hodgkin's Lymphoma (LNH) is increasing in the elderly population. Chemotherapy is the main modality of LNH therapy. The characteristics of the profiles of survival rate and response rate of elderly patients with LNH undergoing chemotherapy are not known in Indonesia. Objective. The objective of the study is to understand the profile, 1-year survival, and response rate of elderly patients with LNH undergoing chemotherapy in Indonesia. Method. This descriptive study was carried out in a retrospective cohort method at the Dr. Cipto Mangunkusumo National General Hospital. Samples were taken by total sampling from medical records in January 2017 - December 2019. Through a review of medical records, patient data that were collected consisted of subject demographics, 1-year survival, nutritional screening, independence status, comorbidities, laboratory, anatomical pathology, toxicity of chemotherapy, and responses evaluation. Results. Of the 78 subjects, the largest age group is 60-69 years (74.35%; n=58), with a median age of 66 years (range 60-91; SD 5.91), male (61,54%; n=48), the 1year survival rate is 58.7%. 17 subjects were only included data in gender, age, and survival percentage calculation due to lack of medical record, the entire data of 61 subjects can be analyzed Of the 61 subjects, the majority of subjects are at risk of malnutrition before undergoing chemotherapy (80.33%; n=49), are included in the category of independent patients before undergoing chemotherapy (55.74%; n=34), has hypertension as the most recorded comorbidity (54.10%; n=33) and has more than 1 comorbid (34.43%; n=21), has Hb levels ≤ 11 before undergoing chemotherapy (42,62%), are aggressive LNH types (65.57%, n=40), are experiencing gastroenterological system toxicity (68.85%; n=42) and hematology (63.93%; n=39), and are experiencing complete responses after 6 cycles of chemotherapy (34.43%; n=21). Conclusion. The majority of elderly patients with LNH who undergo first-line chemotherapy in Indonesia has a profile median age of 66 years old, are male, are aggressive LNH type, are at risk of malnutrition, are independent, have multimorbidities with the most comorbidity is hypertension, have anemia, 1-year survival 58.7%, have gastroenterological and hematological toxicity.
Keywords. Non-Hodgkin's lymphoma, elderly, chemotherapy, survival, response rate.