Patofisiologi dan Diagnosis Infiltrasi Leukemia Limfoblastik Akut ke Sistem Saraf Pusat

Tika Adilistya

Abstract


Acute lymphoblastic leukemia (LLA) is a hematologic malignancy caused by the proliferation of lymphoid cell precursors that cause blast cell accumulation in peripheral blood and bone marrow. Various advances in therapy, such as targeted therapy, have managed to reduce the mortality rate of patients with LLA. One of the fatal complications of LLA is central nervous system involvement (CNS). Patients with CNS involvement are often underdiagnosed both clinically and laboratory. The role of the laboratory is essential for detection of CNS involvement as the difficulty of clinical symptoms is not typical even some patients are asymptomatic. With early detection, patients can be given prophylactic therapy so that the survival rate increases. Despite its many weaknesses, cytologic examination of cytosentrifugation specimens is still considered the gold standard for the diagnosis of leukemic cell infiltration in the CNS. Other tests such as immunophenotyping flow cytometry (FCM) and polymerase chain reaction (PCR) have twice as many diagnostic values when used in combination with cytology, but can not replace the role of cytologic examination. FCM and PCR are useful when CSS sample volume or cell number in CSS is very small. Until now there has been no reliable biochemical marker to detect leukemia SSP


Keywords


leukemia limfoblastik akut; leukemia SSP; ß-2 mikroglobulin; immunophenotyping flow cytometry; PCR; sitologi

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DOI: https://doi.org/10.33476/jky.v25i2.262

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