Dewi A.K. and Ami Ashariati Prayoga and Siprianus Ugroseno Yudho Bintoro (2019) The Effect of CHOP or RCHOP Chemotherapy Regiment on D-dimer Levels of Non-Hodgkin Lymphoma Patients. The New Armenian Medical Journal, 13 (4). pp. 59-67. ISSN 18290825

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Abstract

Background: One of the therapeutic modality in patients with Non-Hodgkin’s lymphoma (LNH) is chemotherapy. Chemotherapy drugs given to Non-Hodgkin’s lymphoma patients could lead to hypercoagulability state due to damage of tumour and endothelial cells. The hypercoagulable state can increase the thromboembolic event rates in Non-Hodgkin’s lymphoma patients receiving chemotherapy. The impact of chemotherapy drugs was measured by D-dimer examination as a marker of coagulation cascade activation and fibrinolysis. Objective: To determine the effects of CHOP or RCHOP chemotherapy on D-dimer levels in Non-Hodgkin’s lymphoma patients. Material and Methods: This was an observational analytic study with pre- and post-test studies. Followed by 30 Non-Hodgkin’s lymphoma patients who have never received chemotherapy. D-dimer level was measured by ELFA examination before and after 3 cycles of CHOP or RCHOP chemotherapy. Results: Most of the patients were men with mean age 49 years, stage III, and histopathology classification of International Working Formulation diffuse of large cell intermediate grade also undergoing RCHOP chemotherapy. The mean D Dimer level of pre chemotherapy was 890.92+ 436.44 ng/ml and the mean of post chemotherapy D-Dimer level was 1714+ 789.34 ng/ml. Wilcoxon sign rank test on D Dimer level pre and post chemotherapy showed significant difference. Analysis of pre and post chemotherapy D Dimer in different regimen namely CHOP and RCHOP also showed significant differences but tended to be higher in RCHOP regimen (p= 0.015). Conclusion: There was a significant increase in post-chemotherapy D Dimer level in patients receiving CHOP or RCHOP regimen

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