Kepatuhan Terapi Kelasi Besi Berdasarkan Kadar Feritin pada Penderita Thalassemia di Rumah Sakit Syamsudin Kota Sukabumi

Refita Trianisya, Ieva Baniasih Akbar, Ismawati Ismawati

Abstract


Abstract. Thalassemia is a blood disorder that results from decreased or lost synthesis of one or more globin chains. Transfusion is indicated in thalassemia patients with an Hb level 7 g / DL. Then to prevent the presence of iron deposits in the body due to repeated transfusions, chelation therapy is needed to reduce the morbidity and mortality rates in thalassemia patients. Several studies found that patients with thalassemia who were adherent to iron chelation therapy had ferritin levels 2500μg / L. The purpose of this study was to describe the adherence of iron chelation therapy in thalassemia patients at Syamsudin SH Hospital. This research used quantitative descriptive method with cross sectional research design. The study population was 148 thalassemia patients based on medical record data with the sampling technique, namely total sampling. This study found that the sex of female 75 patients (50.7%), male gender 73 patients (49.3%), ferritin levels ≤ 2500μg / L (36.48%), ferritin levels> 2500μg / L (63.52%) with a mean ferritin level in all thalassemia patients of 4.607.79

Keywords : Chelation Therapy, Ferritin Levels µg / L. The conclusion of this study that most thalassemia patients were not adherent to taking chelation therapy.

Abstrak. Thalassemia adalah kelainan darah yang terjadi akibat penurunan atau hilangnya sintesis dari satu atau lebih rantai globin. Transfusi diindikasikan pada pasien thalassemia dengan kadar Hb < 7 g/dL. Kemudian untuk mencegah adanya timbunan besi dalam tubuh akibat transfusi berulang dibutuhkan terapi kelasi sehingga mengurangi tingkat morbiditas dan mortalitas pada pasien thalassemia. Beberapa penelitian menemukan bahwa penderita thalassemia yang patuh  dalam menjalankan terapi kelasi besi memiliki kadar feritin <2500μg/L. Tujuan penelitian ini untuk mengetahui gambaran kepatuhan terapi kelasi besi pada pasien thalassemia di RS Syamsudin SH. Penelitian ini menggunakan metode deskriptif kuantitatif dengan desain penelitian cross sectional. Populasi penelitian ini 148 pasien thalassemia berdasarkan data rekam medis dengan teknik pengambilan sampel yaitu total sampling. Penelitian ini mendapatkan hasil jenis kelamin perempuan 75 pasien (50,7%), jenis kelamin laki-laki 73 pasien (49,3%), kadar feritin ≤ 2500μg/L (36,48%), kadar feritin >2500μg/L (63,52%) dengan rerata kadar feritin pada seluruh pasien thalassemia sebesar 4.607,79μg/L. Kesimpulan dari penelitian ini sebagian besar pasien thalassemia tidak patuh dalam mengonsumsi terapi kelasi.

Kata Kunci : Kadar Feritin, Terapi Kelasi


Keywords


Kadar Feritin, Terapi Kelasi

References


Daftar Pustaka

Thalassaemia International Federation. Haemoglobin disorder: Thalassaemia. TIF. Tersedia dari: https://thalassaemia.org.cy/haemoglobin-disorders/thalassaemia/

IDAI. Mengenal Thalasemia. 2016.

Jamison DT, Breman JG, Measham AR, et al., editors. Disease Control Priorities in Developing Countries. 2nd edition. Washington (DC): The International Bank for Reconstruction and Development. The World Bank; 2006. Tersedia dari: https://www.ncbi.nlm.nih.gov/books/NBK11728/ Co-

Alyumnah P, Ghozali M, Dalimoenthe NZ. Skrining Thalassemia Beta Minor Pada Siswa Sma Di Jatinangor. J Sist Kesehat. 2016;1(3):133–8.

GATTO I. Alpha and Beta Thalassemia. Vol. 39, Rassegna clinico-scientifica. 1963;39:333–6.

Miller JL, Tanno T. Iron loading and overloading due to ineffective erythropoiesis. Adv Hematol. 2010.

Complications of thalassemia major and their treatment: Expert Review of Hematology: 2014;4(3)

Cappelini MD CA. Guidelines for the Management of Transfusion Dependent Thakassaemia (TDT) . 3rd Edition. Thalassaemia International Federation; 2014.

Porter JB, Evangeli M, El-Beshlawy A. The challenges of adherence and persistence with iron chelation therapy. International Journal of Hematology. 2011;94:453–60.

Hoffbrand AV, Taher A, Cappellini MD. How I treat transfusional iron overload. 2012;120(18):3657–3669. Tersedia dari: doi: https://doi.org/10.1182/blood-2012-05-370098

Saliba AN, Harb AR, Taher AT. Iron chelation therapy in transfusion-dependent thalassemia patients: Current strategies and future directions. J Blood Med. 2015;6:197–209.

Wood JC. Estimating tissue iron burden: Current status and future prospects. Br J Haematol. 2015;170(1):15–28.

Fortin PM, Fisher SA, Madgwick K V, Trivella M, Hopewell S, Doree C, dkk. Interventions for improving adherence to iron chelation therapy in people with sickle cell disease or thalassaemia. Cochrane Database of Systematic Reviews. 2018.

Gustiana H, Gunantara T, Rathomi HS. Kepatuhan Konsumsi Obat Kelasi Besi dan Kadar Serum Feritin Pasien Talasemia Beta-Mayor di RSUD Al-Ihsan Bandung. J Integr Kesehat Sains. 2020;2(1):26–30.

Kaushansky, Kenneth Lichtman, Marshall A. Prchal J. Williams Hematology, 9E. McGraw Hill Professional; 2015:2528.

Weatherall D. The inherited disorders of haemoglobin: An increasingly neglected global health burden., Indian Journal of Medical Research. 201;134:93–7.

Bernadette M, Matthew D. Global epidemiology of haemoglobin disorders and derived service indicators. Bulletin of the World Health Organization. 2008:417–96. Tersedia dari : https://www.who.int/bulletin/volumes/86/6/06-036673/en/

Marengo-Rowe AJ. The Thalassemias and Related Disorders. Baylor University Medical Center Proceedings. 2007;20:27–3.

Nienhuis AW, Nathan DG. Pathophysiology and clinical manifestations of the β-thalassemias. Cold Spring Harbor Perspectives in Medicine. 2012:2

Kohgo Y, Ikuta K, Ohtake T, Torimoto Y, Kato J. Body iron metabolism and pathophysiology of iron overload. International Journal of Hematology. 2008;88:7–15.

Iron overload in transfusion-dependent thalassemia: Hematology. 2013;20:5.

Hoffbrand A. Essential Haematology. Wiley-Blackwell. 2015;2554. Tersedia dari: http://library1.nida.ac.th/termpaper6/sd/2554/19755.pdf

Solomon LR. Iron-Chelating therapy for transfusional iron overload. New England Journal of Medicine. 2011;364:1475–7.

Delea TE. Consequences and costs of noncompliance with iron chelation therapy in patients with transfusion-dependent thalassemia: A literature review. Transfusion. 2007;47:1919–29. Tersedia dari: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L47438560%5Cnhttp://dx.doi.org/10.1111/j.1537-2995.2007.01416.x%5Cnhttp://link.kib.ki.se/?sid=EMBASE&issn=00411132&id=doi:10.1111%2Fj.1537-2995.2007.01416.x&atitle=Consequences+and+c

Transfusional Iron Chelation Inches Forward. Acta Haematologica. 2019; 142:123–124.

Dehshal MH. Addressing adherence to treatment: a longstanding concern. The patients’ perspective. Thalass Reports. 2014;4(3).

Shah F, Kaltsounis G. Adherence to treatment: Doctor vs patient perspective. Thalass Reports. 2018;8(1).

Evangeli M, Mughal K, Porter JB. Which psychosocial factors are related to chelation adherence in thalassemia a systematic review. Hemoglobin. 2010;34:305–21.

Lee YL, Lin DT, Tsai SF. Disease knowledge and treatment adherence among patients with thalassemia major and their mothers in Taiwan. Vol. 18, Journal of Clinical Nursing. 2009;18:529–38.

Levine L, Levine M. Health care transition in thalassemia: Pediatric to adult-oriented care. Annals of the New York Academy of Sciences. 2010;1202:244–7.

Vichinsky E, Neumayr L, Trimble S, Giardina PJ, Cohen AR, Coates T, et al. Transfusion complications in thalassemia patients: A report from the Centers for Disease Control and Prevention (CME). Transfusion. 2014;54:972–81.

Jain R, Perkins J, Johnson ST, et al. A prospective study for prevalence and/or development of transfusion-transmitted infections in multiply transfused thalassemia major patients. Asian J Transfus Sci. 2012;6(2):151-154. Tersedia dari: doi:10.4103/0973-6247.98919

Loho IKA, Rambert GI, Wowor MF. Gambaran kadar ureum pada pasien penyakit ginjal kronik stadium 5 non dialisis. J e-Biomedik. 2016;4(2).

National Institute for Health and Care Excellence: Clinical Guidelines. London: National Institute for Health and Care Excellence (UK). NICE; 2011;10–51.

Fatmasyithah V, Rahayu M. Gambaran Penderita Thalasemia Di Ruang Rawat Anak Rumah Sakit Umum Cut Meutia Aceh Utara Tahun 2012. J Edukasi dan Sains Biol. 2014;3(2):76799.




DOI: http://dx.doi.org/10.29313/kedokteran.v7i1.26825

Flag Counter