Page 74 - Abstract Book KONIKA 18

Hemato-Oncology

O-HO-005
Corticosteroid Effect during Induction Phase on Vitamin D Level
in Children with Acute Lymphoblastic Leukemia

Hotasi Otana Simanjuntak, Selvi Nafianti, Karina Sugih Arto
Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia

Abstract
Background Chemotherapy induction therapy, by administering corticosteroid, aims to destroy leukemic cells
to <5% and improves patients’ clinical conditions. Vitamin D deficiency was reported to occur in children
with cancer receiving corticosteroid therapy. Corticosteroid therapy that lasted for 6 months reduced bone
mass and increased risk of fractures. Objective To assess corticosteroid effect on vitamin D level in children
with acute lymphoblastic leukemia (ALL). Methods This was a quasi-experimental research method with
pre-post test design approach from December 2020 – July 2021 at Pediatric Hematology-Oncology polyclinic
and ward of Haji Adam Malik Hospital Medan. Blood test before and after steroid administration was done
to asses vitamin D levels. The correlation analysis between corticosteroid therapy and vitamin D levels in
children with ALL was carried out by paired t-test for normally distributed data, otherwise Wilcoxon test was
used. Results Corticosteroid therapy applied was dexamethasone (55.9%) and prednisone (44.1%). There
was no significant relationship observed between average vitamin D level before and after dexamethasone
(P=0.748) and prednisone (P=0.708) administration. The average vitamin D level before and after
corticosteroid therapy was 21.91 ng/mL and 21.32 ng/mL respectively (P=0.619). There were no significant
differences in the diagnostic of vitamin D proportion before and after steroid administration (P=0.059).
Conclusion There was no significant correlation between corticosteroid therapy in induction phase and
vitamin D level reduction in children with ALL.
Keywords: corticosteroid; vitamin D; acute lymphoblastic leukemia

O-HO-006
Diagnosing Iron Deficiency in Children with Cyanotic Heart Disease:
Is Ret-He Beneficial?

Rizqi A. Wicaksana, Piprim B. Yanuarso, Pustika Amalia Wahidiyat, R.A. Setyohandryastuti,
Badriul Hegar Sjarif, Wahyuni Indawati
Department of Child Health, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital,
Jakarta, Indonesia

Abstract
Background Diagnosis of iron deficiency in patients with cyanotic congenital heart disease (CHD)
remains a substantial challenge. Cyanotic CHD leads to chronic hypoxia which triggers erythropoietin
and hemoglobin (Hb)increase. Standard parameters, such as Hb and erythrocyte index are thus unreliable.
Reticulocyte hemoglobin equivalent (Ret-He) is widely used in diagnosing iron deficiency (ID) in patients
with acute inflammation, yet its role in cyanotic CHD cases is unknown. Objective To determine the role
of Ret-He in diagnosing ID in cyanotic CHD patients compared to hematological and iron parameters.
Methods We conducted an observational case series studies of patients at the age of 6 months – 5 years
with cyanotic CHD who met the inclusion and exclusion criteria from March – May 2020. All samples
underwent anamnesis, physical examination and laboratory exam for Hb, MCV, Ret-He, total iron binding
complex (TIBC), serum iron (SI), serum ferritin and CRP. Results We assessed 11 subjects and performed
anthropometric, oxygen saturation, Hb, eritrosit index, SI, TIBC, serum feritin, and Ret-He examinations. Ten
subjects were malnourished, though the nutritional status was not equivalent to the iron status. Low Ret-He
values were found in 9 of 10 subjects with iron storage disorders although no linear association was found.
Conclusion The application of Ret-He as a single diagnostic tool is not recommended in representing iron
status in cyanotic CHD patients. Comprehensive examinations are required to establish the ID diagnosis
in cyanotic CHD.
Keywords: cyanotic congenital heart disease; iron deficiency; reticulocyte hemoglobin equivalent

28 KONIKA XVIII Abstract Book