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Abstrak :
[Kanker merupakan salah satu penyebab kematian utama di dunia, termasuk Indonesia. Berbagai penelitian dilakukan untuk mencari alternatif terapi kanker. Kulit manggis dipercaya mempunyai kandungan senyawa yang bersifat sitotoksik terhadap sel kanker. Penelitian ini bertujuan untuk mengetahui efek sitotoksisitas ekstrak etanol kulit manggis terhadap sel limfoma Hodgkin. Ekstrak yang digunakan berasal dari proses ekstraksi kulit manggis dengan pelarut etanol menggunakan Vaccum Rotary Evaporator pada tekanan 1 atm dengan suhu 60o C. Ekstrak kulit manggis diberikan dalam 8 konsentrasi berbeda yaitu 6,25 μg/ml, 12,5 μg/ml, 25 μg/ml, 50 μg/ml, 100 μg/ml, 200 μg/ml, 400 μg/ml, dan 800 μg/ml. Sitotoksisitas dinilai dengan uji MTT-assay untuk mendapat nilai IC50. Hasil penelitian menunjukkan bahwa ekstrak etanol kulit manggis mempunyai efek sitotoksik terhadap sel limfoma Hodgkin dengan nilai IC50 sebesar 5.6 μg/ml. Uji kemaknaan menggunakan uji Kruskal-Wallis menunjukkan nilai p = 0.008 (p ≤ 0.05). Kesimpulan dari penelitian ini yaitu ekstrak etanol kulit manggis mempunyai efek sitotoksik kuat terhadap sel Limfoma Hodgkin.;Cancer is one of the leading cause of death in the world, including Indonesia. Various studies have been done to seek alternative cancer therapy. Mangosteen pericarp is believed to have substance that are cytotoxic to cancer cells. The purpose of this study is to determine the in vitro cytotoxicity of mangosteen pericarp ethanol extract on Hodgkin Lymphoma cells. The extract used in this study is obtained from the mangosteen pericarp extraction using Vacuum Rotary Evaporator at a pressure of 1 atm and temperature of 60o C. Mangosteen pericarp extract is given in eight different concentration of 6.25 ug / ml, 12.5 pg / ml, 25 mg / ml, 50 pg / ml, 100 pg / ml, 200 mg / mL, 400 mg / ml, and 800 ug / ml. Cytotoxicity was assessed using MTT-assay test to obtain IC50 values. The results showed that ethanol extract of mangosteen pericarp has a cytotoxic effect on Hodgkin lymphoma cells with IC50 value of 5.6 ug / ml. The data were analyzed using Kruskal-Wallis test and had a p value of 0.008 (p ≤ 0.05). The conclusion of this study is that ethanol extract of mangosteen pericarp has a strong cytotoxic effect on Hodgkin lymphoma cells, Cancer is one of the leading cause of death in the world, including Indonesia. Various studies have been done to seek alternative cancer therapy. Mangosteen pericarp is believed to have substance that are cytotoxic to cancer cells. The purpose of this study is to determine the in vitro cytotoxicity of mangosteen pericarp ethanol extract on Hodgkin Lymphoma cells. The extract used in this study is obtained from the mangosteen pericarp extraction using Vacuum Rotary Evaporator at a pressure of 1 atm and temperature of 60o C. Mangosteen pericarp extract is given in eight different concentration of 6.25 ug / ml, 12.5 pg / ml, 25 mg / ml, 50 pg / ml, 100 pg / ml, 200 mg / mL, 400 mg / ml, and 800 ug / ml. Cytotoxicity was assessed using MTT-assay test to obtain IC50 values. The results showed that ethanol extract of mangosteen pericarp has a cytotoxic effect on Hodgkin lymphoma cells with IC50 value of 5.6 ug / ml. The data were analyzed using Kruskal-Wallis test and had a p value of 0.008 (p ≤ 0.05). The conclusion of this study is that ethanol extract of mangosteen pericarp has a strong cytotoxic effect on Hodgkin lymphoma cells]

Abstrak :
Latar Belakang: Limfoma Hodgkin merupakan keganasan yang mencakup 1% kasus kanker keseluruhan. Adapun overall survival (OS) pasien limfoma Hodgkin dalam lima tahun mencapai 90%. Namun, progression-free survival (PFS) limfoma Hodgkin hanya mencapai 70-90% dalam kurun waktu 25 bulan. Setelah mengalami progresivitas, pasien mengalami penurunan PFS setelah mendapat terapi lini kedua. Sehingga, perlu diketahui faktor-faktor prediktor yang mempengaruhi PFS pasien limfoma Hodgkin. Tujuan: Mengetahui faktor-faktor prognostik PFS dua tahun pasien limfoma Hodgkin. Metode: Penelitian ini menggunakan desain kohort retrospektif yang melibatkan pasien limfoma Hodgkin yang teregistrasi dari tahun 2011-2021 di Rumah Sakit Umum Pusat Nasional Dokter Cipto Mangunkusumo. Faktor-faktor prognostik yang diteliti adalah stratifikasi risiko, skor prognosis internasional, kadar trombosit, laktat dehidrogenase, indeks komorbiditas Charlson, dan waktu sejak diagnosis hingga terapi. Analisis multivariat terhadap PFS dua tahun dilakukan menggunakan model regresi Cox. Hasil: Terdapat 115 subjek yang disertakan dalam penelitian dengan median usia 29 tahun, kadar trombosit 393.000 sel/L, LDH 340 IU/L, dan waktu sejak diagnosis hingga terapi enam minggu. Sebagian besar subjek penelitian adalah kelompok stadium lanjut (53,91%), total skor prognosis internasional 0-3 (69,57%), dan total skor indeks komorbiditas Charlson 0-1 (75,65%). Angka PFS dua tahun pasien limfoma Hodgkin di RSCM sebesar 59,13%. Hasil analisis bivariat menunjukkan waktu sejak diagnosis hingga terapi yang tidak memiliki kemaknaan secara statistik dengan HR 0,83 (IK 95% 0,42-1,59, p=0,57). Analisis multivariat menghasilkan tiga faktor prognostik independen, yakni stadium lanjut (HR 7,85 IK 95% 3,01-20,47, p<0,01), trombosit >450.000 sel/L (HR 2,77 IK 95% 1,49-5,16, p<0,01), dan LDH baik 250-500 IU/L (HR 2,57 IK 95% 1,01-3,63, p=0,04) maupun >500 IU/L (HR 3,06 IK 95% 1,20-7,82, p=0,02). Sistem skor berdasarkan ketiga variabel tersebut memiliki diskriminasi yang baik (AUROC 0,879, IK 95% 0,816-0,942, p <0,01). Kesimpulan: Stadium lanjut, trombosit >450.000 sel/L, dan LDH 250 IU/L merupakan faktor-faktor prognostik PFS dua tahun pada pasien limfoma Hodgkin. ......Background: Hodgkin's lymphoma is a malignancy that accounts for 1% of all cancer cases. The overall survival (OS) of Hodgkin's lymphoma patients in five years reaches 90%. However, progression-free survival (PFS) for Hodgkin's lymphoma only reaches 70-90% within 25 months. After experiencing progression, patients experienced a decrease in PFS after receiving second-line therapy. So, it is necessary to know the predictor factors that influence the PFS of Hodgkin's lymphoma patients. Aim: To determine prognostic factors for two-year PFS in Hodgkin's lymphoma patients. Methods: This study used a retrospective cohort design involving Hodgkin's lymphoma patients registered from 2011-2021 at Dokter Cipto Mangunkusumo National General Hospital. The prognostic factors studied were risk stratification, international prognosis score, platelet levels, lactate dehydrogenase, Charlson comorbidity index, and time from diagnosis to therapy. Multivariate analysis of two-year PFS was performed using Cox regression models. Results: There were 115 subjects included in the study with a median age of 29 years, platelet levels of 393,000 cells/L, LDH 340 IU/L, and time from diagnosis to therapy of six weeks. Most of the research subjects were in the advanced stage group (53.91%), the total international prognosis score was 0-3 (69.57%), and the total Charlson comorbidity index score was 0-1 (75.65%). The two-year PFS rate for Hodgkin's lymphoma patients at RSCM was 59.13%. The results of bivariate analysis showed that the time from diagnosis to therapy was not statistically significant with HR 0.83 (95% CI 0.42-1.59, p=0.57). Multivariate analysis yielded three independent prognostic factors, namely advanced stage (HR 7.85, 95% CI 3.01-20.47, p<0.01), platelets >450,000 cells/L (HR 2.77, 95% CI 1.49-5.16, p<0.01), and LDH either 250-500 IU/L (HR 2.57, 95% CI 1.01- 3.63, p=0.04) or >500 IU/L (HR 3.06 95% CI 1.20-7.82, p=0.02). The scoring system based on these three variables had good discrimination (AUROC 0.879, 95% CI 0.816- 0.942, p <0.01). Conclusion: Advanced stage, platelets >450,000 cells/L, and LDH >250 IU/L are prognostic factors for two-year PFS in Hodgkin's lymphoma patients.