SISTEM IMUN DAN HEMATOLOGI PDF

Blood Cancer Journal edisi 30 Juni memuat riset yang meneliti kemungkinan rasio ALC absolute lymphocyte count , hitung limfosit absolut dan AMC absolute monocyte count , hitung monosit absolut dalam memperkirakan perkembangan penyakit prognosis pada pasien multiple myeloma. Monosit dan limfosit adalah jenis sel darah putih. Namun, hingga kini, jumlah biomarka penanda biologis imun yang bisa mencerminkan status tubuh pasien dan memprediksi hasil klinis masih sangat kurang. Inilah yang mendorong para peneliti. Riset melibatkan pasien yang baru saja terdiagnosis multiple myeloma di University Hospitals Cleveland Medical Center dan University of Cincinnati di Ohio, Amerika Serikat, selama hingga

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Blood Cancer Journal edisi 30 Juni memuat riset yang meneliti kemungkinan rasio ALC absolute lymphocyte count , hitung limfosit absolut dan AMC absolute monocyte count , hitung monosit absolut dalam memperkirakan perkembangan penyakit prognosis pada pasien multiple myeloma. Monosit dan limfosit adalah jenis sel darah putih. Namun, hingga kini, jumlah biomarka penanda biologis imun yang bisa mencerminkan status tubuh pasien dan memprediksi hasil klinis masih sangat kurang.

Inilah yang mendorong para peneliti. Riset melibatkan pasien yang baru saja terdiagnosis multiple myeloma di University Hospitals Cleveland Medical Center dan University of Cincinnati di Ohio, Amerika Serikat, selama hingga Riset sejenis sudah pernah dilakukan di Korea, namun jumlah pasien lebih sedikit.

Riset ini memperbanyak jumlah pasien yang diteliti, sekaligus menegaskan kembali hasil riset sebelumnya. Blood Cancer Journal 7, e; doi Correspondence: E Malek, E-mail: ehsan. The advent of novel therapies has significantly changed the therapeutic landscape in multiple myeloma MM.

However, MM remains largely incurable and patients undergo disease relapse frequently after a short remission period. This is partly because MM is characterized by the loss of critical mediators of immune surveillance and the development of an immunologic milieu that fosters both disease progression and resistance to therapy. In fact, novel anti-MM agents such as bortezomib and lenalidomide exert many of their effects via immunomodulation in addition to direct cytotoxic effect against myeloma cells.

We also correlate this biomarker with known adverse cytogenetics in MM. The bone marrow BM microenvironment plays a critical role in the development of MM from its precursor condition, monoclonal gammopathy of undetermined significance MGUS , in part by allowing immune tumor evasion. The ALC of healthy individuals stays in a narrow range in their lifespan, deviating significantly only during illness.

Interestingly, a longitudinal study in elderly men demonstrated that a decrease in ALC is associated with a three-year mortality from any cause.

We also correlated these immune subsets to known adverse cytogenetics to better understand how the latter correlate with immune dysfunction in MM.

The study was approved by the institutional review boards at both institutions. Patients with a history of HIV or immunosuppression therapy were excluded. The primary end-point was progression-free survival PFS from time of diagnosis. Statistical analysis was performed using SAS software version 9. In our cohort, the median age was To define a cutoff point, the choices of AMC 0.

Out of patients, patients had cytogenetics available at diagnosis—our panel included del 17p , t 4;14 , t 11;14 , and hyperdiploidy; 1q gain was not available. Our median follow up period was Patients who were lost to follow up were censored from the survival analysis. Baseline serum creatinine was not significantly different between these groups. Low ALC and high AMC individually showed significant correlation with these factors in univariate analysis, but failed to be significant in multivariate analysis data not shown.

Cutoff points ALC 1. Progression-free survival PFS and overall survival OS of myeloma patients based on baseline immune parameters. Full figure and legend K. Full table. Interestingly, although previous studies had suggested ALC as a prognostic marker, recent investigations with the novel agents failed to demonstrate statistical significance.

To our knowledge, these findings have only once been suggested in a smaller Korean cohort 14 —our study in a larger cohort confirms and expands these findings in an immune context. Although both adverse cytogenetics and immunoparesis are known adverse prognostic factors in MM, it is unknown whether there exists a pathophysiological mechanism.

Our study supports research into mechanisms linking these cytogenetics and immune dysfunction in the MM microenvironment. The search for immune biomarkers that help stratify patients based on their immune status is ever important in an era of upcoming immunotherapies. Although several immune-based modalities carry promise in changing the anti-myeloma therapy landscape, they suffer from major drawbacks that include variable response rates, induction of de novo autoimmune disease, and other inflammatory and autoimmune toxicities.

Ongoing and future studies could incorporate this readily available biomarker in identifying treatment-naive MM patients that are best suited for immunotherapies. Top of page. Your email address will not be published. Skip to content. Ringkasan Blood Cancer Journal edisi 30 Juni memuat riset yang meneliti kemungkinan rasio ALC absolute lymphocyte count , hitung limfosit absolut dan AMC absolute monocyte count , hitung monosit absolut dalam memperkirakan perkembangan penyakit prognosis pada pasien multiple myeloma.

Memprediksi masa tanpa perkembangan penyakit progression-free survival , PFS dan masa keseluruhan sintasan overall survival , OS. Sumber Blood Cancer Journal 7, e; doi Figure 1.

Table 1B — Univariate and multivariate analysis for progression-free survival and overall survival. Top of page Conflict of interest The authors declare no conflict of interest.

The immunotherapy era of myeloma: monoclonal antibodies, vaccines, and adoptive T-cell therapies. Blood ; : — Is immunotherapy here to stay in multiple myeloma?

Haematologica ; : — Cytogenetic profiles in multiple myeloma and monoclonal gammopathy of undetermined significance: a study in highly purified aberrant plasma cells. Haematologica ; 98 : — Multiple myeloma macrophages: pivotal players in the tumor microenvironment.

J Oncol ; : Oncotarget ; 5 : — Tumor-associated macrophages as a prognostic parameter in multiple myeloma. Ann Hematol ; 92 : — Oncologist ; 17 : — Myeloid-derived suppressor cells: the green light for myeloma immune escape. Blood Rev ; 30 : — Absolute peripheral blood lymphocyte count and subsequent mortality of elderly men.

J Am Geriatr Soc ; 34 : — Clinical value of absolute lymphocyte counts before bortezomib-dexamethasone therapy in relapsed multiple myeloma patients. Acta Haematol ; : 34— Absolute lymphocyte count as predictor of overall survival for patients with multiple myeloma treated with single autologous stem cell transplant.

Leuk Lymph ; 56 : — Absolute lymphocyte count is unrelated to overall survival in newly diagnosed elderly patients with multiple myeloma treated with immunomodulatory drugs. Absolute lymphocyte count as a prognostic marker in newly diagnosed multiple myeloma patients.

Int J Lab Hematol ; 38 : e56—e Korean J Pathol ; 47 : — Validation of biomarkers to predict response to immunotherapy in cancer: volume I—pre-analytical and analytical validation. J Immunother Cancer ; 4 : Visit Ibu Bungan asal Kaltim. Uji Klinis Keytruda Dihentikan Sebagian. Leave a Reply Cancel reply Your email address will not be published.

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Rasio ALC/AMC sebagai Biomarka Imun Prognostik pada Multiple Myeloma

Sistem komplemen adalah protein dalam serum darah yang bereaksi berjenjang sebagai enzim untuk membantu sistem kekebalan seluler [1] dan sistem kekebalan humoral [2] untuk melindungi tubuh dari infeksi. Protein komplemen tidak secara khusus bereaksi terhadap antigen tertentu, dan segera teraktivasi pada proses infeksi awal dari patogen. Oleh karena itu sistem komplemen dianggap merupakan bagian dari sistem imun bawaan. Walaupun demikian, beberapa antibodi dapat memicu beberapa protein komplemen, sehingga aktivasi sistem komplemen juga merupakan bagian dari sistem kekebalan humoral. Protein komplemen di dalam serum darah merupakan prekursor enzim yang disebut zimogen.

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