Hubungan Penyakit Alergi dan Atopi dengan Kejadian Leukemia pada Anak

Abstract

Background. Relationship between allergies and leukemia is still controversy. Allergy is a risk factor for leukemia but can also become a protective factor. Immune response activation induce preleukemia cells or allergiy increases the capacity of the immune system to detect and destroy aberrant cells. Objective. To determine the relationship of allergic diseases and atopy with the occurence of leukemia in children. Methods. A case-control study conducted in pediatric allergy immunology and hemato-oncology division, for 2 months. Children aged 3-17 years old with leukemia in the study group, and children without leukemia as the control group. The diagnosis of leukemia was established by bone marrow punction. Skin prick tests to assess atopy and International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire to assess allergic diseases. We used the X2 Results. Examination of 70 subjects found 35 (50%) children with leukemia and 35 (50%) children without leukemia. One child found allergic disease and atopy in 13 children in the case group, while in the control group we found 9 allergic disease and atopy in 31 children. There is a relationship between allergic diseases with leukemia (OR = 0.085 95% CI 0.01-0.714) and relationship between atopy and leukemia (OR = 0.349 95% CI 0.215-0.567). In leukemia there is one with allergic rhinitis, 7 children with allergic rhinitis in control, 3 with bronchial asthma and atopic dermatitis in 1 child. There was no relationship between type of allergy and leukemia which were allergic rhinitis (OR= 0.118) and bronchial asthma (OR=2.094) and atopic dermatitis (OR=2.029). Atopy in children is a protective factor against leukemia (OR <1). test, and Fischer exact logistic regression for statistical analysis. Conclusion. There is a significant relationship between allergic diseases and atopy with leukemia, and there is no significant relationship between the type of allergic disease with leukemia. Atopy acts as a protective factor against leukemia.

Latar belakang. Hubungan alergi dan leukemia masih merupakan kontroversi. Alergi merupakan faktor risiko leukemia dan studi lain melaporkan alergi sebagai faktor protektif. Aktivasi respons imun menginduksi sel preleukemia atau alergi meningkatkan kapasitas sistem imunitas untuk mendeteksi dan menghancurkan sel yang menyimpang. Tujuan. Mengetahui hubungan penyakit alergi dan atopi dengan kejadian leukemia pada anak. Metode. Penelitian case-control di divisi alergi imunologi dan hemato-onkologi selama 2 bulan. Usia 3-17 tahun dengan leukemia sebagai kasus sedangkan anak tanpa leukemia sebagai kontrol. Diagnosis leukemia berdasarkan pemeriksaan aspirasi sum-sum tulang. Uji tusuk kulit untuk menilai atopi dan kuesioner International Study of Asthma and Allergies in Childhood (ISAAC) menilai penyakit alergi. Analisis menggunakan uji X2 , Fischer exact dan regresi logistik Hasil. Penelitian 70 subjek yaitu 35 (50%) leukemia dan 35 (50%) anak tanpa leukemia. Ditemukan penyakit alergi 1 orang dan atopi 13 orang pada kasus, sedangkan pada kontrol penyakit alergi 9 orang dan atopi 31 orang. Terdapat hubungan signifikan antara penyakit alergi dengan leukemia (OR= 0.085, 95% CI 0.01-0.714) dan terdapat hubungan signifikan antara atopi dengan leukemia (OR=0.349 95% CI 0.215-0.567). Pada leukemia terdapat rinitis alergik 1 orang, sedangkan pada kontrol rinitis alergik 7 orang, asma 3 orang dan dermatitis atopik 1 orang. Tidak terdapat hubungan jenis alergi dengan leukemia, dimana asma bronkial (OR=2.094), rinitis alergik (OR=0.118) dan dermatitis atopik (OR=2.029). Atopi pada anak merupakan faktor protektif terhadap leukemia (OR<1).