PROFIL DASAR FUNGSI HATI DAN GINJAL PADA ANAK DENGAN LEUKEMIA LIMFOBLASTIK AKUT

BASELINE HEPATIC AND RENAL FUNCTION PROFILES IN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA

Abstract

Leukemia limfoblastik akut (LLA) merupakan keganasan tersering pada anak dan membutuhkan terapi intensif yang berpotensi menimbulkan komplikasi organ. Penilaian fungsi hati dan ginjal dasar pada saat diagnosis penting dilakukan untuk mendukung pengambilan keputusan klinis yang aman sebelum inisiasi kemoterapi. Penelitian ini bertujuan untuk menggambarkan profil fungsi hati dan ginjal dasar pada anak dengan LLA yang baru terdiagnosis. Penelitian ini menggunakan desain observasional potong lintang dan dilakukan di pusat rujukan hematologi-onkologi anak pada periode Juli 2024 hingga Januari 2025. Subjek penelitian adalah 40 anak berusia ≤18 tahun dengan diagnosis LLA yang belum mendapatkan terapi. Parameter fungsi hati yang dinilai meliputi aspartat aminotransferase (AST), alanin aminotransferase (ALT), dan albumin serum, sedangkan parameter fungsi ginjal meliputi blood urea nitrogen (BUN) dan kreatinin serum. Analisis statistik mencakup analisis deskriptif, uji perbandingan berdasarkan usia dan jenis kelamin, serta analisis korelasi antarparameter. Hasil penelitian menunjukkan adanya peningkatan AST dan ALT pada sebagian pasien dengan korelasi positif yang kuat (r = 0.707; p < 0.001), yang mencerminkan stres hepatoseluler dini. Kadar albumin relatif terjaga dan tidak berkorelasi bermakna dengan transaminase, menunjukkan fungsi sintetik hati yang masih baik. Parameter ginjal umumnya berada dalam batas normal, dengan korelasi positif bermakna antara BUN dan kreatinin (r = 0.314; p = 0.048), mengindikasikan variasi subklinis fungsi ekskresi ginjal. Tidak ditemukan perbedaan bermakna berdasarkan usia dan jenis kelamin, kecuali kreatinin yang dipengaruhi faktor fisiologis usia. Penelitian ini menegaskan bahwa evaluasi fungsi hati dan ginjal dasar memiliki signifikansi klinis penting dalam penatalaksanaan awal LLA anak, meskipun kelainan yang ditemukan bersifat ringan dan subklinis.

Kata kunci: Karakteristik Dasar, Leukemia Limfoblastik Akut, Onkologi Anak, Profil Ginjal, Profil Hati

Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy and requires intensive chemotherapy that may predispose patients to organ-related complications. Assessment of baseline hepatic and renal function at diagnosis is essential to support safe clinical decision-making prior to treatment initiation. This study aimed to describe baseline hepatic and renal function profiles in children with newly diagnosed ALL. A cross-sectional observational study was conducted at a tertiary pediatric hematology–oncology center between July 2024 and January 2025. Forty treatment-naive children aged ≤18 years with confirmed ALL were included. Baseline hepatic function parameters assessed included aspartate aminotransferase (AST), alanine aminotransferase (ALT), and serum albumin, while renal function parameters included blood urea nitrogen (BUN) and serum creatinine. Statistical analyses comprised descriptive analysis, comparisons by on age and sex, and correlation analyses among laboratory parameters. Elevated AST and ALT levels were observed in a subset of patients, with a strong positive correlation between the two enzymes (r = 0.707; p < 0.001), indicating hepatocellular stress at diagnosis. Serum albumin levels were generally preserved and showed no significant correlation with transaminases, suggesting intact hepatic synthetic function despite elevated enzyme levels. Renal function parameters were largely within age-appropriate ranges, with a significant positive correlation between BUN and serum creatinine (r = 0.314; p = 0.048), reflecting subtle variations in renal excretory function without overt impairment. No significant differences in hepatic or renal parameters were observed according to age or sex, except for creatinine, which likely reflected physiological age-related variation. These findings suggest that mild hepatic and renal alterations may already be present at diagnosis in pediatric ALL. Systematic baseline evaluation of organ function, even when abnormalities appear subclinical, remains clinically important for treatment planning, monitoring strategies, and prevention of therapy-related complications.

Keywords: Acute Lymphoblastic Leukemia, Baseline Characteristics, Hepatic Profile, Pediatric Oncology, Renal Profile