makalah kanker darah

8/17/2019 Makalah Kanker Darah

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Menegakkan diagnosis kanker darah

Perkembangan sel darah sampai menyebabkan kanker

Ciri2

Penyebab kanker darah (factor resiko)

Jenis-jenis

Pencegahan

Pengobatan

Merancang makanan pada pasien kanker ko

DA!A" #$#

SAMPUL ................................................................................................................KATA PENGANTAR..............................................................................................

DAFTAR ISI.............................................................................................................

BAB I PENDAHULUAN...............................................................................

A. LATAR BELAKANG.....................................................................

B. KOMPONEN SISTEM PEREDARAN DARAH....................................

I. DARAH.............................................................................................

II. PEMBULUH DARAH.....................................................................

III. JANTUNG.........................................................................................

C. PEREDARAN DARAH MANUSIA.............................................. .........

D. KELAINAN DAN GANGGUAN PADA SISTEM PEREDARAN

DARAHE. TEKNOLOGI PADA SISTEM PEREDARAN DARAH.......................

BAB II PEMBAHASAN..........................................................................................

A. PENGERTIAN LEUKIMIA (KANKER DARAH)................................

B. TANDA-TANDA PENYAKIT LEUKIMIA (KANKER DARAH)

C. PENYEBAB LEUKIMIA (KANKER DARAH)....................................

D. KOMPLIKASI YANG TERLIBAT DALAM LEUKIMIA KRONIK

E. PENCEGAHAN LEUKIMIA..................................................................

F. PENGOBATAN LEUKIMIA...................................................................

BAB III PENUTUP..................................................................................................

A. KESIMPULAN.........................................................................................

B. SARAN......................................................................................................

DAFTAR PUSTAKA...............................................................................................


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%A% #

P&'DA*A'

A+ *A!A" %&*A,A'

Dalam hi!"#$a% &'a#im* m*m*'l!+a# ma+a#a# a# &+i*# !#,!+

m*la#!#+a# m*,a&lim*. P'&* m*,a&lim*% *lai# m*#hail+a# a,-a,

$a# *'!#a /!a m*#hail+a# am"ah (a, ia) $a# ha'! i+*l!a'+a# a'i

,!!h. Baha#-aha# $a# i"*'l!+a# ,!!h *"*',i ma+a#a#%&+i*#% hail

m*,a&lim* a# ia#$a ia#+!, a# i*a'+a# ialama ,!!h m*lal!i i,*m

"*'*a'a# a'ah. Hail "*#0*'#aa# ma+a#a# a# &+i*# ia#+!, a# i*a'+a#

&l*h a'ah +**l!'!h /a'i#a# ,!!h% *m*#,a'a ia-ia m*,a&lim* ia#+!,

&l*h a'ah a'i *l!'!h /a'i#a# ,!!h m*#!/! &'a#-&'a# "*m!a#a#.

%+ ,.MP.'&' $#$!&M P&"&DA"A' DA"A#+ DA"A

P*#*',ia# a'ah

Da'ah aalah /a'i#a# ,*'"*ialiai $a# m*#0a+!" 0ai'a# +*+!#i#a# a,a!

"lama a'ah $a# ialam #$a ,*'+a#!# *l-*l a'ah. S*l-*l a'ah ,*'i'i a'i

*l a'ah m*'ah ( *'i,'&i, )% *l a'ah "!,ih (l*!+&i, ) a# +*"i# a'ah

( ,'&m&i, ).

K&m"&ii "lama alam a'ah *+i,a' 11 2% *a#+a# *l-*l a'ah a#

,'&m&i, *+i,a' 31 2 l.

S*l a# +*"i# a'ah l*ih *'a, ia#i#+a# "lama *hi#a a"a, i "iah+a#

m*lal!i "'&*!' $a# i *!, *#,'i4!ai. ( Ma'i* 56637 S&l&m*, al.5661 ).

F!#i a'ah 8


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9. M*#a#+!, &+i*# +* /a'i#a# i *l!'!h ,!!h

5. M*#a#+!, a'i-a'i ma+a#a# +**l!'!h ,!!h

:. M*#a#+!, ia-ia m*,a&lim*% *"*',i +a' i&+ia% !'*a%a# aam

la+,a, +*ala, *++'*i.

9. M*#*a'+a# h&'m a'i +*l*#/a' h&'m +*,*m"a, $a#

m*m!,!h+a#.

5. M*#a,!' "H ,!!h% m*#a,!' !h! ,!!h% m*la;a# ii, "*#$a+i,

*',a m*la+!+a# m*+a#im* "*m*+!a# a'ah.

a. Plasma darah

Paa ma#!ia% "lama a'ah m*#a#!# *+i,a'


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b. Sel-sel darah

S*l-*l a'ah aalah *l-*l $a# hi!". S*l-*l a'ah ,ia+ ,*'*lah% m*lai#+a#

la#!# i a#,i &l*h *l-*l a'! a'i !m-!m ,!la# *la+a#.

Ada tiga macam sel-sel darah yaitu :

1. Eritrosit ( Sel darah merah )

> E'i,'&i, *'*#,!+ "i"ih *#a# a'i ,*#ah ?%10m% *'i,'&i, 0*+!# iaia#

,*#ah#$a ( i++a4 ) a# ,ia+ *'i#,i. ( I,ama' $am!'i%++.566@ ).

> a'#a *'i,'&i, ,*'a#,!# "aa h*m&l&i#. H*m&l&i# *'4!#i m*#i+a,

&+i*# ( O5 )% /i+a h*m&l&i# m*#i+a, O5% ma+a *'i,'&i, a+a# *';a'#a

m*'ah% /i+a O5 ,*lah i l*"a+a# ma+a ;a'#a#$a m*#/ai m*'ah +*i'!a#.

> P'&* P*m*#,!+a# *'i,'&i, i *!, *'i,'&"&i*i.

> S*l $a# a"a, m*m*#,!+ *'i,'&i, aalah h*m&i,&la ( *l a,a# mi*l&i )

$a# mam"! *'+*ma# m*#/ai *'aai *l a'a. Dalam +*aaa# #&'mal%

*'i,'&i, *',aha# *lama 'a,a-'a,a 956 ha'i. Saa, *l m*#!a% m*m'a# *l 'a"!h

a# "*0ah. E'i,'&i, ,!a im!#ah+a# i&'a# lim"a ( li*# ) a# ha,i.

> J!mlah E'i,'&i, *'a'iai% ,*'a#,!# /*#i +*lami#% !ia a# +*,i#ia# ,*m"a,

,i#al **&'a#. K*#,'ai *'i,'&i, "aa la+i-la+i #&'mal aalah 8 1%9-1%= /!,a

"*'milili,*' +!i+ a'ah% a# "aa ;a#i,a #&'mal 3%:-1%5 /!,a "*'milili*,*' +!i+

a'ah.

2+ Leukosit ( sel darah Putih)

- T*'a"a, *#am /*#i l*!+&i, alam a'ah $ai,! #*!,'&4il% *&i#&4il% a&4il m&i,%

lim4&i, a# *l "lama. N*&,'&4il% *&i#&4il% a# a&4il m*mili+i 'a#!la-'a#!la

*hi#a *'i# i*!, 'a#!l&i,. S*a#+a# lim4&i, a# m&i, i *!,

a'a#!lai, ( ,ia+ *''a#!la ).

- Baha#-aha# $a# i "*'l!+a# !#,!+ m*m*#,!+ l*!+&i, aalah !i,ami# a#

aam ami#& *"*',i hal #$a *l-*l lai##$a.


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- O'a# *;aa m*mili+i *+i,a' 3.=66-96.=66 l*!+&i, "*'milili,*' +!i+ a'ah%

,*'i'i a'i @52 #*!,'&4il% 5.:2 *&i#&4il% 6%3 2 a&4il% 1%: 2 m&i,% a# :6 2

lim4&i,.

- Maa hi!" l*!+&i, *'*a-*a% 'a#!l&i, *+i,a' 95 /am% m&i, !li, i#ilai

+a'*#a *lal! m*#*ma'a% ,*,a"i i!a *lama **'a"a mi#! a,a! !la#%

lim&4i, !m!m#$a *',ah!# *lama 966-:66 ha'i.

3. Trombosit ( keping-keping darah )

> T'&m&i, *'!#a !#,!+ m*#!m"al+a# a'ah% K*"i# a'ah *'*#,!+ 0a+'am

a# ,ia+ *'i#,i> Maa hi!" ,'&m&i, *+i,a' =-96 ha'i% *,*lah i,! +*"i# a'ah a+a# ia;ah

+*lim"a !#,!+ i ha#0!'+a#.

> J!mlah +*"i# a'ah aalah 916 'i! 6 366 'i! "*' mm: a'ah.

c. Mekanisme Penggumpalan arah

P*m*+!a# a'ah ,*'/ai alam ,ia ,aha" $ai,! 8

9. Ja'i#a# l!+a "a"a' +* a'ah% ,'&m&i, a+a# m*#*m"*l +* +&l&*# /a'i#a# a#

m*#*l!a'+a# a,-a, $a# m*m!a, ,'&m&i, ali# *'*+a,a# a# m*#*m"*l.

5. T'&m&i, a+a# m*m*#,!+ !ma, $a# m*m*'i "*'li#!#a# a'!'a, *hi#a

,*'/ai +*hila#a# a'ah.

:. P*m*#,!+a# *#a#-*#a# 4i'i#.

- Fa+,&' "*#!m"ala# a'ah a'i ,'&m&i, *'0am"!' *#a# 4a+,&'

"*#!m"ala# a'ah a'i "lama a'ah.- T'i# a+a# m*#+a,alii "*'!aha# #i'i#&a# m*#/ai *#a#-*#a# 4i'i#.

d. Penggolongan darah

9. Al!,i#&*# aalah a#,i*#-a#,i*# alam *'i,'&i, $a# m*m!a,

*l "*+a ,*'haa" "*#!m"ala# a'ah ( al!,i#ai ).


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5. Al!,i#i# aalah !,a#i $a# m*#$*a+a# al!,i#a#i *l

mial#$a a#,i &i. D'.+a'l la#,*i#*' *&'a# ahli im!#&l&i a#

"a,&l&i *'+*a#aa# A!,'ia ( 9=@=-9


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##+ P&M%* DA"A

Paa aa +* 9? *&'a# ahli 4ii&l&i a'i i#'i% $a#i illiam Ha'*$

( 91?= 9@1? )% a'i hail "*'0&aa##$a a# *'aai "*'0&aa# ahli lai#

i,*m!+a#lah "*m!l!h ali+ ( *#a ).

Tia "!l!h ,ah!# +*m!ia# *&'a# ahli a#a,&mi i,alia Ma'0*ll& Mal"ihi.

B*'hail m*#*m!+a# "*m!l!h a'ah +a"ill*'.

a+ Pembuluh "adi ( #rteri )

P*m!l!h #ai aalah "*m!l!h $a# m*ma;ah a'ah a'i /a#,!# a#

!m!m#$a m*#a#!# a#$a+ &+i*#. Paa aa, /a#,!# *'+,'a+i ( i,& )

a'ah a+a# +*l!a' a'i ili+ m*#!/! "*m!l!h #ai. P*m!l!h i#i ,*al% *la,i%

a# m*mili+i *!ah +!,!" ( al!la *mil!#'i ) $a# *'aa ,*'a"a, il!a'

/a#,!#.

Aa !a "*m!l!h #ai $a# il*;a,i a'ah $ai,! 8

9. P*m!l!h #ai *a' ( a&',a ).

A&',a aalah "*m!l!h $a# il*;a,i a'ah a'i ili+ +i'i /a#,!# m*#!/!

+**l!'!h ,!!h.

5. P*m!l!h #ai "a'!-"a'! ( a',*'i "almali ).

P*m!l!h #ai "a'!-"a'! aalah "*m!l!h $a# il*;a,i a'ah a'i ili+ +a#a#

m*#!/! "a'!-"a'! ( "!lm& ).

b+ Pembuluh $alik ( %ena )

P*m!l!h ali+ aalah 8 P*m!l!h $a# m*ma;a a'ah +*mali +*/a#,!#%

$a# !m!m#$a m*#a#!# +a'i&+ia. Paa aa, /a#,!# *'*la+ai


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( Dia,&l )% a'ah a'i ,!!h a# "a'!-"a'! a+a# ma!+ +* /a#,!# m*lalal!i *#a.

*#a i*l!!#i &l*h &,&, 'a#+a a# m*mili+i *!ah +a,!" $ai,! al!la

S*mil!#a'i.

P*m!l!h ali+ $a# ma!+ +* /a#,!# aalah *aai *'i+!, 8

9. *#a Kaa

*#a +aa *'0aa#-0aa# m*#/ai "*m!l! $a# l*ih +*0il $ai,! *#a. Aa

!a ma0am *#a +aa% $ai,! *#a +aa !"*'i&' a# *#a +aa i#4*'i&'.

- *#a +aa !"*'i&'

*#a i#i m*ma;a a'ah $a# m*#a#!# CO5 a'i aia# a,a ,!!h ( +*"ala%

l*h*'% +**'ami +a#a# /a#,!#.

- *#a +aa i#4*'i&'

*#a i#i m*ma;a a'ah $a# m*#a#!# CO5 a'i aia# ,!!h lai##$a a#

a#&,a aa# a;ah ,!!h +**'ami +a#a# /a#,!#.

5. *#a P!lmali

*#a i#i m*ma;a a'ah $a# m*#a#!# O5 a'i "a'!-"a'! +**'ami +i'i

/a#,!#.

###+ JA'!'+

Ja#,!# ,*'l*,a+ ialam 'a aa *',a ,*'!#+! &l*h Pa'i+a'ia. Pa'i+a'ia

,*'i'i a'i !a la"i $ai,! 8

- Lami#a "a'i*,ali ( **lah l!a' )% a#

- Lami#a i*'ali ( m*#*m"*l i i#i# /a#,!#. )

Dia#,a'a +*!a la"i ,*'*!, ,*'a"a, +a!m "a'i+a'ia $a# *'ii 0ai'a#

"i'i+a'ia.

Ja#,!# ,*'i'i a'i 3 '!a# $ai,! 8 !a *'ami ( a,'i!m ) a# !a ili+ (*#,'i+*l).


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Ja#,!# i*#,!+ ,*'!,ama &l*h ,ia /*#i &,&, /a#,!# ( mi&+a'ia ) $ai,!% &,&,

*'ami% &,&, ili+ % *',a *'a!, &,&, "*'a#a# a# "*#a#,a' +h!!.

- D*,a+ Ja#,!#

D*,a+ /a#,!# *,ia" &'a# *'*a-*a ,*'a#,!# "aa !ia% *'a, aa#% /*#i

+*lami#% +**ha,a#% a# a+,i4i,a *&'a#. Paa aa, !!+% *#$!, #ai **&'a#

?5 "*'m*#i,. T*,a"i "aa aa, *'i'i *#$!, #ai m*#0a"ai =: "*'m*#i,.

Paa a#a+-a#a+% *#$!, #ai #$a l*i 0*"a, ia#i#+a# &'a# *;aa. O'a#

,*'+*/!, *#$!, #ai#$a m*#/ai l*ih 0*"a,. ( I,ama' S$am!'i%++8566@ )


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C+ P&"&DA"A' DA"A MA'$#A+

Aa !a ma0am "*'*a'a# a'ah alam ,!!h ma#!ia $ai,! 8

9. P*'*a'a# a'ah +*0il.

Aalah "*'*a'a# a'ah iili+ +a#a# /a#,!# m*#!/! "a'!-"a'! m*l*;a,i a',*'i

"!lmali a# +*mali +* *'ami +i'i /a#,!# m*l*;a,i *#a "!lmali.

5. P*'*a'a# a'ah *a'

Aalah "*'*a'a# a'ah a'i ili+ +i'i /a#,!# +* *l!'!h ,!!h m*lal!i a&',a a#

a+hi'#$a +*mali +* *'ami +a#a# /a#,!# m*lal!i *#a +aa.

Ol*h +a'*#a "aa ma#!ia ,*'a"a, +*!a ma0am "*'*a'a# a'ah ,*'*!,% ma+a

ma#!ia i +a,a+a# m*mili+i "*'*a'a# a'ah a#a.

D+ ,&*A#'A' DA' A'A' PADA $#$!&M P&"&DA"A' DA"A+

K*lai#a# a,a! a#!a# "aa i,*m "*'*a'a# a'ah a#,a'a lai# 8

9. A#*mia ( K!'a# Da'ah ).

Di+a'*#a+a# +!'a##$a a'ah H a,a! +!'a##$a /!mlah *'i,'&i, alam a'ah.

5. a'ii%aalah "*l*a'a# "*m!l!h a'ah i *,i.

:. H*m&'&i ( Ami*# )% Aalah "*'*a'a# "*m!l!h a'ah i*+i,a' !!' (a#!).

3. A',*'i& +l*'&i% ialah "*#*'aa# "*m!l!h #ai +a'*#a ,im!#a# a,a! *#a"a#

+a"!'.

1. A,h*'&+l*'&i% ialah "*#*'aa# "*m!l!h #ai +a'*#a *#a"a# l*ma+.

@. Em&l!% ialah ,*'!ma,#$a "*m!l!h a'ah +a'*#a *#a $a# *'*'a+.

?. T'&m!% ialah ,*'!ma,#$a "*m!l!h a'ah +a'*#a *#ah $a# ,ia+ *'*'a+.


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=. H*m&4ilia% ialah +*lai#a# a'ah !+a' m*m*+! +a'*#a 4a+,&' h*'*i,a a,a!

+*,!'!#a#.


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%A% ##

P&M%AA$A'

A+ P&'&"!#A' *&,#M#A (,A',&" DA"A)

L*!+imia aalah !a,! "*#$a+i, $a# i+*#al *#a# aa#$a "'&li4*'ai

#*&"lai,i+ a'i *l-*l &'a# h*m&"&i*,i+% $a# ,*'/ai *aai a+ia, m!,ai

&ma,i+ *l a+al (,*m 0*ll) $a# a+a# m*m*#,!+ !a,! +l *l l*!+imia.

P*#$a+i, +a#+*' a'ah (l*!+imia) m*#!!+i "*'i#+a, ,*',i#i +a#+*' "aa

a#a+. Nam!#% "*#a#a#a# +a#+*' "aa a#a+ i I#*ia maih lama,. I,!lah

*a#$a l*ih a'i @62 a#a+ "*#*'i,a +a#+*' $a# i,a#a#i *0a'a m*i !ah

m*ma!+i ,ai!m la#/!,.

L*!+imia m*'!"a+a# +*a#aa# h*m&"&i*,i+ $a# m*#a+ia,+a# "'&li4*'ai

+l $a# a#&'mal a# *l a+al m*#alami ,'a#4&'mai l*!+imia% ,*'/ai

+*lai#a# "aa i4*'*#iai a# "*',!m!ha# a'i *l lim4&i a# mi*l&i.

Dia#&a l*!+imia a+!, a"a, i,*a++a# a'i "*m*'i+aa# h*ma,&l&i H%

l*!+&i,% ,!la#% $ai,! ,i"* l*!+imia a+!, *'aa'+a# +lai4i+ai FAB.

P*;a'#aa# i,&+imia a"a, m*#+i'mai aal l*!+imia a+!, a"a+ah a'i lim4&i

a,a! mi*l&i. D*#a# "*m*'i+aa# imm!#&"h*#&-,$"i# ia#&i l*!+imia a+!,

a"a, i+*,ah!i a"a+ah mi*l&i a,a! lim4&i% ah+a# LLA a"a, ii4*'*#iai

l*ih la#/!, a"a+ah a'i *l T a,a!+ah *l B. P*m*'i+aa# i,&*#i+ a+a# m*m*'i

"*,!#/!+ aa,ia+#$a a*'ai +'&m&&m.

T*lah ila+!+a# "*#*li,ia# "aa *la"a# !$*+ L*!+imia a+!,% ,*'i'i a'i *m"a,

a#a+-a#a+% *&'a# '*ma/a% !a *;aa a# *&'a# Ma#!la (,ia &'a#

"*'*m"!a# a# lima &'a# la+i-la+i). Um!' *'+ia' a#,a'a 3-=5 ,ah!#.


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LMA ,*'a"a, "aa *m"a, !$*+% a#a+ ,ia*la ,ah!# LMA-M:% !a *;aa

LMA-M5 a# *&'a# Ma#!la LMA-M5. LLA *l T "aa !a !$*+% *&'a#

a#a+ a# *&'a# *;aa. LLA *l B "aa !a !$*+% *&'a# a#a+ a# *&'a#

*;aa. LLA *l T i,a#ai aa#$a CD:% CD1% a# CD?7 LLA *l B i,a#ai

aa#$a CD96% CD 9


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%+ !A'DA-!A'DA P&'/A,#! *&,#M#A (,A',&" DA"A)

Ta#a-,a#a "*#$a+i, l*!+*mia (+a#+*' a'ah) a"a, iama'+a# *aai

*'i+!,8

9. A#*mia. P*#*'i,a a+a# m*#am"a++a# 0*"a, l*lah% "!0a, a# *'#a4a 0*"a, (*l

a'ah m*'ah ia;ah #&'mal m*#$*a+a# &$*# alam ,!!h +!'a#%

a+ia,#$a "*#*'i,a *'#a4a 0*"a, *aai +&m"*#ai "*m*#!ha# +*+!'a#a#

&$*# alam ,!!h).

5. P*'a'aha#. K*,i+a Pla,*l*, (*l "*m*+! a'ah) ,ia+ ,*'"'&!+i *#a# ;a/a'

+a'*#a i&mi#ai &l*h *l a'ah "!,ih% ma+a "*#*'i,a a+a# m*#alami

"*'a'aha# i/a'i#a# +!li, (a#$a+#$a /*#,i+ m*'ah l*a'+*0il i/a'i#a# +!li,).

:. T*'*'a# I#4*+i. S*l a'ah "!,ih *'"*'a# *aai "*li#!# a$a ,aha# ,!!h%

,*'!,ama m*la;a# "*#$a+i, i#4*+i. Paa P*#*'i,a L*!+*mia% *l a'ah "!,ih

$a# i,*'*#,!+ aalah ,ia+ #&'mal (a#&'mal) *hi#a ,ia+ *'4!#i

*m*,i#$a. A+ia,#$a ,!!h i "*#*'i,a '*#,a# ,*'+*#a i#4*+i i'!a+,*'i%

ah+a# *#a# *#i'i#$a a+a# m*#am"a++a# +*l!ha# aa#$a *mam% +*l!a'

0ai'a# "!,ih a'i hi!# (m*l*') a# a,!+.

3. N$*'i T!la# a# P*'*#ia#. Hal i#i i*a+a# *aai a+ia, a'i !m!m

,!la# (* ma''&;) m*#*a+ "aa, &l*h *l a'ah "!,ih.

1. N$*'i P*'!,. N$*'i "*'!, /!a m*'!"a+a# alah a,! i#i+ai */ala l*!+*mia%

ima#a *l l*!+*mia a"a, ,*'+!m"!l "aa &'a# i#/al% ha,i a# *m"*! $a#

m*#$*a+a# "*m*a'a# "aa &'a#-&'a# ,!!h i#i a# ,im!lah #$*'i. N$*'i

"*'!, i#i a"a, *'am"a+ hila##$a #a4! ma+a# "*#*'i,a l*!+*mia.

@. P*m*#+a+a# K*l*#/a' L$m"a. P*#*'i,a +*m!#+i#a# *a' m*#alami

"*m*#+a+a# "aa +*l*#/a' l$m"a% ai+ i,! $a# ia;ah l*#a#% l*h*'% aa

a# lai##$a. K*l*#/a' l$m"a *',!a m*#$a'i# a'ah% *l l*!+*mia a"a,

,*'+!m"!l ii#i a# m*#$*a+a# "*m*#+a+a#.


15/41

?. K*!li,a# B*'#a4a (D$"#*a). P*#*'i,a m!#+i# m*#am"a++a# */ala +*!li,a#

*'#a4a a# #$*'i aa% a"aila ,*'/ai hal i#i ma+a ha'! **'a m*#a"a,+a#

"*',&la# m*i.

C+ P&'/&%A% *&,#M#A (,A',&" DA"A)

U#,!+ "*#$*a *#i'i am"ai aa, i#i maih *l!m i+*,ah!i. T*,a"i

+*a#$a+a# ,*lah i,*m!+a# **'a"a 4a+,&' "*#$*a#$a. A#,a'a lai#8

9. Raiai

M*#!'!, a,a% LMA l*ih i*a+a# +a'*#a *'a#a# 'aiai. S*a# LLK

*#i'i /a'a# m*#a"a, la"&'a# +a'*#a 4a+,&' 'aiai. ii;% /ai aa

+*m!#+i#a# "*a;ai 'ai&l&i ia m*mili+i +*m!#+i#a# ,*'+*#a *'a#a#

L*!+*mia S**#a'#$a !#,!+ *'a#a# L*!+*mia "aa a#a+-a#a+ *#i'i

m*#i#+a, *,*lah "*#*&ma# Hi'&hima a# Naaa+i i J*"a#. S*m*#/a+ i,!%

m!lai a#$a+ la"&'a# m*#*#ai a#a+-a#a+ $a# m*#*'i,a L*!+*mia i#i. T-T

5. Fa+,&' L*!+*m&*#i+

Ma+!#$a ii#i i,! +a'*#a 4a+,&' a, +imia ,*',*#,!. Biaa#$a Ra0!# li#+!#a#

*"*',i *#*#a7 I#*+,iia7 &a,-&a,a# ,*'a"i +a$a +*m&,*'a"i /!a a+a#

m*m!#+i#+a# ,*'/ai#$a L*!+*mia. *h /ai K*m&,*'a"i i L*!+*mia /!a

a+a# m*#a+ia,+a# L*!+*mia /*#i a'! U#,!+ i,! ia;ah #a#,i A*

/*lai# l*ih al*m +&+.. H*h*..

:. i'!

i'! i#i iaa#$a ih i'! HTL "*#$*a !,ama#$a. HTL i,! T-cell

Leukemia Viruses $a# m*'!"a+a# "*#$*a !,ama a'i +*,ia+ #&'mala#


16/41

"*'+*ma#a# *l a'ah "!,ih. Biaa#$a ih HTL I a,a! II. i'! lai##$a a#,a'a

lai# '*,'&i'! a,a! i'! l*!+*mia 4*li#*.

3. H*'*i,*'

H*'*i,*' ii#i ma+!#$a +*,!'!#a#. Biaa#$a &'a# $a# m*mili+i Si#'&m

D&;# l*ih '*#,a# ,*'+*#a L*!+*mia ia#i# $a# ,ia+. K*m!#+i#a#

,*'+*#a#$a *+i,a' 56 +ali l*ih '*#,a# ia#i# $a# #&'mal.

D+ ,.MP*#,A$# /A' !&"*#%A! DA*AM *&,#M#A ,".'#,

9. P*m*#+a+a# #&! lim"a i l*h*'% +*,ia+%"*'!,%a,a! +*mal!a#.

5. Raa a+i, $a# ,*'!+ ,*'!,ama#$a i a;ah ,*'#!m.

:. Raa l*,iha# a# l*!a#

3. K*hila# *'a, ,a#"a *a ,*',*#,!.

1. D*mam

@. M*#*'ima l*am *#a# *#a#.

?. Raa a+i, "aa ,!la#.

=. Kaa' "*'#a4aa# '*#ah( h&',#* &4 '*a,h).


17/41

&+ P&'C&AA' *&,#M#A

M*la+!+a# *,*+i i#i +a#+*' !#,!+ "*#0*aha#. P*#0*aha##$a *#a#

m*#!mi i,ami# A a# C% !ah ma!"!# a$!'a# $a# +a$a a+a# *'a,.

U#,!+ "*m*'i+aa# Dia#&i "*#$a+i, i#i a"a, ila+!+a# *#a# **'a"a 0a'a%

ia#a,a#$a aalah *#a#8

9. P*m*'i+aa# m&'4&l&i8 a'ah ,*"i% a"i'ai !m!m ,!la#% i&"i !m!m

,!la#

5. P*;a'#aa# Si,&+imia

:. Imm!#&4*#&,i"*

3. Si,&*#*,i+a

1. Dia#&,i0 S*l!l*'

+ P&'.%A!A' *&,#M#A

P*#$*m!ha# L*!+*mia *#i'i a"a, ila+!+a# *#a# **'a"a 0a'a. Mial#$a8

9. K*m&,*'a"i *#a# &a,7 "*#!#aa# i#i *'i4a, m*#$*'a# a#

m*#ha#0!'+a# *l-*l +a#+*' "a,&l&i $a# m*#$*'a# a+a# ,!!h. Nah

+ala! ,ai "*#!#aa# +*m&,*'a"i a"a, m*#a+ia,+a# +a#+*' a'!

m*ma# *#a'. Biaa#$a "*#!#aa# &a, i#i i,amah+a# *#a# &a,

"*#hama, m!#0!l#$a "*#$a+i, a'!. Biaa#$a &a, $a# i!#a+a#

aalah hydrea 0 hydroksi1rea mercapto p1rinetol dan myleran. R&$

P*'i;i#+l* i h!,a# maaa+a' *'i# /!a i!#a+a# !#,!+

"*#$*m!ha# L*!+*mia i#i. Sa$a##$a ,!m!ha# i#i ,*'a#0am "!#ah.


18/41

5. Raiai7 P*#!#aa##$a *#i'i *#a# &i ,i#i $a# #a#,i#$a

ia+!m!lai+a# "aa a*'ah *'a+!m!lai#$a *l l*!+*mia.

:. T'a#"la#,ai S!m!# ,!la# *la+a#7 iaa#$a aalah !m!m ,!la#

*la+a# a'i a!a'a +a#!# a,a! a!a'a *+a,. K*!#,!#a##$a aalah

i*m im!# ,ia+ a+a# a+,i4 !#,!+ m*m!#!h *l hail ,'a#"la#,ai.

K*'!ia##$a *#i'i aalah *l $a# a+a# *'4!#i alam ;a+,! $a#

a#a, lama% ,ia+ a+a# *'4!#i *#a# ai+ alam ;a+,! $a# i#+a,.


19/41

%A% ###P&'!P

A+ ,&$#MP*A'

L*!+imia aalah !a,! "*#$a+i, $a# i+*#al *#a# aa#$a "'&li4*'ai

#*&"lai,i+ a'i *l-*l &'a# h*m&"&i*,i+% $a# ,*'/ai *aai a+ia, m!,ai

&ma,i+ *l a+al (,*m 0*ll) $a# a+a# m*m*#,!+ !a,! +l *l l*!+imia.

P*#$a+i, +a#+*' a'ah (l*!+imia) m*#!!+i "*'i#+a, ,*',i#i +a#+*'

"aa a#a+. Nam!#% "*#a#a#a# +a#+*' "aa a#a+ i I#*ia maih lama,.

I,!lah *a#$a l*ih a'i @62 a#a+ "*#*'i,a +a#+*' $a# i,a#a#i *0a'a m*i

!ah m*ma!+i ,ai!m la#/!,.

Ca'a m*#0*ah P*#$a+i, L*!+imia $ai,! 8

M*la+!+a# *,*+i i#i +a#+*' !#,!+ "*#0*aha#. P*#0*aha##$a *#a#

m*#!mi i,ami# A a# C% !ah ma!"!# a$!'a# $a# +a$a a+a# *'a,.

%+ $A"A'

S*,*lah a#a m*ma0a ma+alah i#i% *m&a a#a aa' a# m*#*'ima a'a# a'i

a$a $ai,! 8

9. Tia+ m*'&+&+ aa' a'ah ,ia+ '!a+ a# ,*'i#4*+i.

5. Bai $a# m*'aa i'i#$a *ha,% ilah+a# *+ali-+ali !#,!+ m*m*'i+a+a# i'i#$a

+* D&+,*' aa' l*ih /*la'*al a'i *'a#a# "*#$a+i, L*!+imia (Ka#+*' Da'ah).


20/41

DA!A" P$!A,A

DA. P'a,i;i% S'i ma'$a,i% S'i+i#i% S!ha'#&% a# Bama# S. P*#*'i, 8 E'la#a

566@. Bi&l&i !#,!+ SMA K*la I.Jili 5 Ja+a',a. P*#*'i, E'la#a.

I,ama' S$am!'i% [email protected]&l&i !#,!+ SMP K*la III. Jili 5. Ja+a',a 8

P*#*'i, E'la#a.

%A% 3

P&'DA*A'

3+3 *atar %elakang

L*!+*mia aalah #*&"lama a+!, a,a! +'i a'i *l-*l "*m*#,!+ a'ah alam!m!m ,!la# a# lim4a #ai (R***% 5669).

I#i*#i L*!+*mia i Am*'i+a aalah 9: "*' 966.666 "*#!!+ ,ah!# ( il%

9


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9. M*#*,ah!i a# m*m"*la/a'i l*ih alam m*#*#ai "*#$a+i, L*!+*mia.

5. M*#*,ah!i ,a,a la+a#a a# a!ha# +*"*'a;a,a# "aa +li*# L*!+imia.

:. M*#*+'i"i+a# ia#&a +*"*'a;a,a# $a# m!#0!l "aa a!ha#

+*"*'a;a,a# +li*# *#a# "*#$a+i, L*!+*mia.

3. M*#*+'i"i+a# '*#0a#a +*"*'a;a,a# $a# i!a, "aa a!ha#

+*"*'a;a,a# +li*# *#a# *#a# L*!+*mia.

1. M*#*+'i"i+a# ,i#a+a#-,i#a+a# $a# ha'! ila+!+a# "aa a!ha#

+*"*'a;a,a# +li*# *#a# L*!+*mia.

%A% ##P&M%AA$A'

2+ 3 Pengertian

L*!+*mia% aal *'aal a'i ahaa $!#a#i l*!+&-"!,ih a# haima-a'ah.

L*!+*mia aalah /*#i +a#+*' $a# m*m"*#a'!hi !m!m ,!la# a# /a'i#a#

*,ah *#i#. S*m!a +a#+*' *'m!la i *l% $a# m*m!a, a'ah a# /a'i#a#

lai##$a. Biaa#$a% *l-*l a+a# ,!m!h a# m*m*lah i'i !#,!+ m*m*#,!+ *l-

*l a'! $a# i!,!h+a# ,!!h. Saa, *l-*l *ma+i# ,!a% *l-*l ,*'*!, a+a#

ma,i a# *l-*l a'! a+a# m*#a#,i+a##$a.Ta"i% ,*'+aa# "'&* $a# ,*'a,!' i#i *'/ala# m*#$im"a#% S*l-*l a'! i#i

,*'*#,!+ m*+i ,!!h ,ia+ m*m!,!h+a##$a% a# *l-*l lama ,ia+ ma,i *"*',i

*ha'!#$a. K*/a#ala# i#i i*!, l*!+*mia% i ma#a !m!m ,!la#

m*#hail+a# *l-*l a'ah "!,ih a#&'mal $a# a+hi'#$a m*#*a+ *l-*l lai#.

%eberapa pengertian men1r1t para ahli4

• L*!+imia aalah "'&li4*'ai *l a'ah "!,ih $a# maih ima,!' alam

/a'i#a# "*m*#,!+ a'ah. (S!'iai% Ri,a $!lia#i% 5669 8 9?1).

• L*!+imia aalah "'&li4*'ai ,a+ ,*'a,!' a,a! a+!m!lai *l a'ah "!,ihalam !m-!m

,!la# m*#a#,i+a# *l*m*# !m-!m ,!la# #&'mal (Sm*l,*'% S C a#

Ba'*% B.G% 5665 8 53= )

• L*!+imia aalah !a,! +*a#aa# "aa ala, "*m!a, *l a'ah *'!"a

"'&li4*'ai&

"a,&l&i *l h*m&"&*,i+ m!a $a# i,a#ai &l*h aa#$a +*aala# !m-

!m ,!la#

alam m*m*#,!+ *l a'ah #&'mal a# aa#$a i#4il,'ai +* /a'i#a# ,!!h

$a# lai#.

(A'i*4 Ma#/&*'% ++% 5665 8 3


22/41

• L*!+*mia aalah #*&"lama a+!, a,a! +'i a'i *l-*l "*m*#,!+ a'ah

alam !m!m ,!la# a# lim4a #ai (R***% 5669).

B*'aa'+a# a'i **'a"a "*#*',ia# ia,a ma+a "*#!li *'"*#a"a, ah;a

l*!+*mia aalah !a,! "*#$a+i, $a# i*a+a# &l*h "'&li4*'ai a#&'mal a'i

*l-*l l*!+&i, $a# m*#$*a+a# ,*'/ai#$a +a#+*' "aa ala, "*m*#,!+ a'ah.

2+2 &tiologi

P*#$*a $a# "a,i *l!m i+*,ah!i% a+a# ,*,a"i ,*'a"a, 4a+,&' "'*i"&ii

$a# m*#$*a+a# ,*'/ai#$a l*!+*mia% $ai,! 8

9. enetik

Aa#$a P*#$im"a#a# K'&m&&m I#i*#i l*!+*mia m*#i#+a, "aa "*#*'i,a

+*lai#a# +*#i,al% ia#,a'a#$a "aa i#'&ma D&;#% i#'&ma Bl&&m%

Fa#0i A#*mia% i#'&ma i+&,,-Al'i0h% i#'&ma Elli a# C'**l%

i#'&ma Kl*i#4*l,*'% D-T'i&m$ i#'&m*% i#'&ma R*0+i#ha!*#% a#

#*!'&4i'&ma,&i ( i*'#i+% 9


23/41

9


24/41

9) Mani!estasi klinis

K*a#$a+a# ,a#a a# */ala ,*'/ai a+ia, *'+!'a##$a "'&!+i *l a'ah#&'mal. K*"*+aa# ,*'haa" i#4*+i ,*'/ai a+ia, 'a#!l&i,&"*#ia% +*+!'a#a#

'a#!l&i,7 +*l*laha# a# +*l*maha# $a# ,*'/ai +a'*#a a#*mia7 a#

+*00*#'!#a# "*'a'aha# ,*'/ai a+ia, ,'&m&i,&"*#ia% +*+!'a#a# /!mlah

,'&m&i,. P'&li4*'ai *l l*!+*mi alam &'a# m*#a+ia,+a# *'aai */ala

,amaha#7 #$*'i a+ia, "*m*a'a# lim"a a,a! ha,i7 maalah +*l*#/a' lim4a7 a+i,

+*"ala a,a! m!#,ah a+ia, l*!+*mia m*#i#*al (*'i# ,*'/ai "aa l*!+*mia

lim4&i,i+)7 a# #$*'i ,!la# a+ia, "*#$*a'a# !m!m ,!la#.

K*lai#a# i#i ,*'/ai ,a#"a "*'i#a,a#% *#a# */ala ,*'/ai alam "*'i&* 9-@

!la#. Hi,!# *l a'ah m*#!#/!+a# "*#!'!#a# ai+ *'i,'&i, ma!"!# ,'&m&i,.

M*+i"!# /!mlah l*!+&i, ,&,al ia '*#ah% #&'mal a,a! ,i#i% #am!# "'**#,a**l $a# #&'mal iaa#$a a#a, m*#!'!#. S"*0im*# !m!m ,!la# m*'!"a+a#

"*#*a+ ia#&*% m*#!#/!+a# +*l*iha# *l la, ima,!'. Aa#$a a,a# A!*'

ialam i,&"lama m*#!#/!+a# aa#$a l*!+*mia mi*l&*#! a+!, (AML).

5) Penatalaksanaan

K*m&,*'a"i m*'!"a+a# *#,!+ ,*'"i !,ama a# "aa **'a"a +a! a"a,

m*#hail+a# "*'ai+a# $a# *'la#!# am"ai *,ah!# a,a! l*ih. Oa, $a#

iaa#$a i!#a+a# m*li"!,i a!#&'&i0i# h$'&0hl&'i* (0*'!ii#*)% 0$,a'ai#

(0$,&a'-U)% a# m*'0a",&"!'i#* ("!'i#*,h&l). A!ha# "*#!+!# ,*'i'i a,a

"*m*'ia# "'&!+ a'ah a# "*#a#a#a# i#4*+i *#a# **'a. A"aila a"a,

i"*'&l*h /a'i#a# $a# 0&0&+ a'i +*'aa, *+a,% ma+a a"a, ila+!+a#

,'a#"la#,ai !m!m ,!la# !#,!+ m*m"*'&l*h !m!m ,!la# #&'mal% *,*lah

,*'l*ih ah!l! ila+!+a# "*#ha#0!'a# !m!m l*+*mi+ *#a# +*m&,'a"i.

:) Prognosis

Pai*# $a# m*#a"a,+a# "*#a#a#a# a"a, *',aha# ha#$a am"ai 9 ,ah!#%

*#a# +*ma,ia# $a# iaa#$a ,*'/ai a+ia, i#4*+i a,a! "*'a'aha#. S0hill*'

(9


25/41

CML /a'a# m*#$*'a# i#ii! *'!ia i a;ah 56 ,ah!#% #am!# i#i*#i#$a

m*#i#+a, *!ai "*',amaha# !ia.

1) Mani!estasi

Gama'a# +li#i CML mi'i" *#a# ama'a# AML% ,*,a"i ,a#a a# */ala#$a

l*ih 'i#a#. Ba#$a+ "ai*# $a# m*#!#/!++a# ,a#a */ala *lama *',ah!#-

,ah!#. T*'a"a, "*#i#+a,a# l*!+&i,% +aa# am"ai /!mlah $a# l!a' iaa.

Lim"a *'i# m*m*a'.

&) Penatalaksanaan dan Prognosis

T*,a"i "iliha# l*!+*mia mi*l&*#! +'i aalah !l4a# (M$l*'a#)%

h$'&$!'*a% a# 0hl&'am!0il (L*!+*'a#) *#i'i a,a! *#a# +&',i+&,*'&i.

K*,aha#a# hi!" m*#i#+a, *0a'a *'ma+#a *#a# ,'a#"la#,ai !m!m ,!la#

"aa "ai*# $a# *'!ia i a;ah 16 ,ah!# *#a# &' HLA $a# *!ai.

I#,*'4*' al4a m*'!"a+a# al,*'#a,i* "iliha# "*#a#a#a#% #am!# a#a, mahal%

m*m"!#$ai *4*+ am"i# $a# ,ia+ m*#$*#a#+a# a# ,ia+ ,*'!+,i

m*m"*'"a#/a# +*,aha#a# hi!". Fl!a'ai# (Fl!a') *4*+,i4 ai "ai*# $a#

"*#$a+i,#$a ,ia+ *'*" ,*'haa" "*#a#a#a# $a# ,*lah ila+!+a# a,a! ,*'!m*m*'a, *,*lah "*#a#a#a#. Paa +*a#$a+a# "ai*#% +*la+ a+a# m*#alami

l*!+*mia mi*l&*#! a+!, a# iaa#$a '*i,*# ,*'haa" ,*'a"i a"a"!#. S*0a'a

+**l!'!ha#% "ai*# a"a, *',aha# *lama : am"ai 3 ,ah!#. K*ma,ia# iaa#$a

a+ia, i#4*+i a,a! "*'a'aha#.

9. c+ *e1kimia *imfositik Ak1t+

L*!+*mia lim4&i,i+ a+!, (ALL) ia#a" *aai !a,! "'&li4*'ai a#a

lim4&la. Pali# *'i# ,*'/ai "aa a#a+-a#a+% *#a# la+i-la+i l*ih a#$a+ia#i# "*'*m"!a#% *#a# "!#0a+ i#i*#i "aa !ia 3 ,ah!#. S*,*lah !ia

91% ALL /a'a# ,*'/ai.

1) Mani!estasi

Lim4&i, ima,!' *'"'&li4*'ai ala# !m!m ,!la# a# /a'i#a# "*'i4*' a#

m*#a#! "*'+*ma#a# *l #&'mal. A+ia,#$a% h*ma,&"&*i #&'mal

,*'lama,% m*#a+ia,+a# "*#!'!#a# /!mlah l*!+&i,% *l a'ah m*'ah% a#

,'&m&i,. E'i,'&i, a# ,'&m&i, /!mlah#$a '*#ah a# l*!+&i, /!mlah#$a a"a,

'*#ah a,a! ,i#i ,*,a"i *lal! ,*'a"a, *l ima,!'. Ma#i4*,ai i#4il,'ai l*!+*mia

+* &'a#-&'a# lai# l*ih *'i# ,*'/ai "aa ALL a'i "aa *#,!+ l*!+*mia lai#


26/41

a# m*#a+ia,+a# #$*'i +a'*#a "*m*a'a# ha,i a,a! lim"a% a+i, +*"ala% m!#,ah

+a'*#a +*,*'lia,a# m*#i#*% a# #$*'i ,!la#.

&) Penatalaksanaan dan Prognosis

T*'a"i ALL ,*lah m*#alami +*ma/!a#% *+i,a' @62 a#a+ m*#0a"ai +*,aha#a#

hi!" am"ai 1 ,ah!#. B*#,!+ ,*'a"i !,ama aalah +*m&,*'a"i *#a# +&mi#ai

i#0'i,i#*% "'*#i*% a!#&'!i0i#% a# a"a'ai#a* !#,!+ ,*'a"i a;al a#

ila#/!,+a# *#a# +&mi#ai m*'0a",&"!'i#*% m*,h&,'*a,*% i#0'i,i#*% a#

"'*#i* !#,!+ "*m*liha'aa#. Raiai !#,!+ a*'ah +'a#i&"i#al a# i#/*+i

i#,'a,*+al &a, +*m&,*'a"i a"a, m*ma#,! m*#0*ah +*+am!ha# "aa i,*m

a'a4 "!a,.

9. d+ *e1kimia *imfositik ,ronis

L*!+imia lim4&i, +'i (CLL) 0*#*'!# m*'!"a+a# +*lai#a# 'i#a# $a#

,*'!,ama m*#*#ai i#ii! a#,a'a !ia 16-?6 ,ah!#. N*a'a- N*a'a a'a,

m*la"&'+a# "*#$a+i, i#i *aai l*!+*mia $a# !m!m ,*'/ai.

1) Mani!estasi klinis

K*a#$a+a# "ai*# ,ia+ m*#!#/!+a# */ala a# a'! ,*'ia&a "aa aa,

"*m*'i+aa# 4ii+ a,! "*#a#a#a# !#,!+ "*#$a+i, lai#. Ma#i4*,ai $a# m!#+i#

,*'/ai aalah *h!!#a# *#a# aa#$a a#*mia% i#4*+i% a,a! "*m*a'a# #&!

lim4*. Da# &'a# a&mi#al. J!mlah *'i,'&i, a# ,'&m&i, m!#+i# #&'mal a,a!

m*#!'!#. T*'/ai "*#!'!#a# /!mlah lim4&i,. (lim4&i,&"*#ia).

P*#a,ala+a#aa# m*i a# "'&#&i. A"aila 'i#a#% CLL ,ia+ m*m*'l!+a#

"*#a#a#a#. K*m&,*'a"i *#a# +&',i+&,*'&i a# 0hl&'am!0il (l*!+*'a#)*'i# i!#a+a# a"aila */ala#$a *'a,. Ba#$a+ "ai*# $a# ,ia+ *'*"

,*'haa" ,*'a"i i#i a"a, m*#0a"ai "*'ai+a# *#a# "*m*'ia# 4l!a'ai#*

m&4&"a,% 5-0h&'&*&$a*#&i*# (5-CBA)% a,a! "*#,&,a,i#. E4*+ am"i#

!,ama &a, i#i aalah "*#*+a#a# !m!m ,!la#% $a# ,*'ma#i4*,ai *#a#

aa#$a i#4*+i *"*',i "#*!m&0$,i 0a'i#ii% li,*'ia% mi+&a+,*'ia% i'! h*'"*

a# i,&m*al&i'!. P*#a#a#a# i#,'a *#a *#a# imm!#&l&!li# 0!+!"

*4*+,i4 m*#0*ah maalah i#i "aa "ai*# ,*',*#,!. K*,aha#a# hi!" 'a,a-'a,a

"ai*# *#a# CLL aalah ? ,ah!#.

&) 'omplikasi


27/41

K&m"li+ai l*!+*mia m*li"!,i "*'a'aha# a# i#4*+i% $a# m*'!"a+a# "*#$*a

!,ama +*ma,ia#. P*m*#,!+a# a,! i#/al% a#*mia% a# maalah a,'&i#,*,i#al

m*'!"a+a# +&m"li+ai lai#.

Rii+& "*'a'aha# *'h!!#a# *#a# ,i#+a, *4ii*#i ,'&m&i,

(,'&m&i,&"*#ia) a#+a ,'&m&i, '*#ah i,a#ai *#a# m*ma' (*+im&i) a#

"*,*+ia (i#,i+ "*'a'aha#-"*'a'aha# a,a! +*a!a# **a' !/!# /a'!m

i"*'m!+aa# +!li,). Pai*# /!a a"a, m*#alami "*'a'aha# *'a, /i+a /!mlah

,'&m&i,#$a ,!'!# am"ai i a;ah 56.666 "*' mm: a'ah. D*#a# ala a# $a#

,ia+ /*la% *mam a# i#4*+i a"a, m*#i#+a,+a# +*m!#+i#a# "*'a'aha#.

Ka'*#a +*+!'a#a# 'a#!l&i, ma,!' a# #&'mal% "ai*# *lal! alam +*aaa#

,*'a#0am i#4*+i. K*m!#+i#a# ,*'/ai#$a i#4*+i m*#i#+a, *!ai *'a/a,

#*,'&"*#ia% *hi#a /i+a 'a#!l&i, *'aa i a;ah 966ml a'ah a#a,m!#+i# ,*'/ai i#4*+i i,*mi+. Di4!#i im!# m*m"*',i#i '*i+& i#4*+i.

P*#ha#0!'a# *l *a'-*a'a# $a# ,*'/ai *lama "*m*'ia# +*m&,*'a"i a,a!

m*#i#+a,+a# +aa' aam !'a, a# m*m!a, "ai*# '*#,a# m*#alami

"*m*#,!+a# a,! i#/al a# +&li+ i#/al. Ma+a "ai*# m*m*'l!+a# a!"a# 0ai'a#

$a# ,i#i !#,!+ m*#0*ah +'i,aliai aam !'a, a# "*m*#,!+a# a,!.

Maalah a,'&i#,*,i#al a"a, ,*'/ai a+ia, i#4il,'ai l*!+&i, a#&'mal +* &'a#

a#&mi#al *lai# a+ia, ,&+ii,a &a, +*m&,*'a"i. S*'i# ,*'/ai a#&'*+ia% m!al%

m!#,ah% ia'*% a# l*i m!+&a m!l!,.

2+7 Patofisiologi

L*!+*mia a+!, a# +'i m*'!"a+a# !a,! *#,!+ +*a#aa# a,a! mali#a $a#

m!#0!l a'i "*'a#$a+a# +lal *l-*l "*m*#,!+ *l a'ah $a# ,ia+ ,*'+,'&l

m*+a#im* +,'&l *l!l*' #&'mal m!#+i# ,ia+ *+*'/a *#a# ai+ a+ia,

aa#$a "*'!aha# "aa +&* *#*,i+ $a# *ha'!#$a *',a#!# /a;a a,a

"*#a,!'a# "*',!m!ha# *l a# i4*'*#iai.

S*l-*l l*!+*mia m*#/ala#i ;a+,! a!' !la# $a# l*ih lama, ia#i#+a# *l

#&'mal. P'&* "*ma,a#a# a,a! ma,!'ai *'/ala# ,ia+ l*#+a" a# lama, *',a *',aha# hi!" l*ih lama ia#i#+a# *l #&'mal.

2+8 Manifestasi ,linis

Ma#i4*,ai +li#i+ $a# *'i# i/!m"ai "aa "*#$a+i, l*!+*mia aalah *aai

*'i+!,8

9. Pil*+ ,ia+ *m!h-*m!h a+i, +*"ala.


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5. P!0a,% l*!% m!ah ,*',im!lai% M*'aa l*mah a,a! l*,ih.

:. D*mam% +*'i#a, malam a# a#&'*ia

3. B*'a, aa# m*#!'!#

1. P,*0hia*% m*ma' ,a#"a *a% M!ah *'a'ah a# l*am (!i *'a'ah%

*'0a+ +*!#!a# i +!li,% a,a! i#,i+-i#,i+ m*'ah +*0il i a;ah +!li,)

@. N$*'i "aa ,!la# a# "*'*#ia#

?. N$*'i a&m*#% P*m*#+a+a# a,a! 'aa ,ia+ #$ama# i "*'!, (a+ia,

"*m*a'a# lim"a).

2+9 Pemeriksaan Pen1njang

9. Hi,!# a'ah l*#+a" 8 m*#!#/!++a# #&'m&i,i+% a#*mia #&'m&i,i+

5. H*m&l&!li# 8 a"a, +!'a# a'i 96 '966ml

:. R*,i+!l&i, 8 /!mlah iaa$a '*#ah

3. T'&m&i, 8 a#a, '*#ah (Q 16666mm)

1. SDP 8 m!#+i# l*ih a'i 166660m *#a# "*#i#+a,a# SDP imma,!'

@. PTT 8 m*ma#/a#

?. LDH 8 m!#+i# m*#i#+a,

=. Aam !'a, *'!m 8 m!#+i# m*#i#+a,


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S*aia# *a' "ai*# l*!+*mia m*#/ala#i +*m&,*'a"i. J*#i "*#&a,a# +a#+*'

i#i m*#!#a+a# &a,-&a,a# !#,!+ m*m!#!h *l-*l l*!+*mia. T*'a#,!# "aa

/*#i l*!+*mia% "ai*# ia m*#a"a,+a# a,! /*#i &a, a,a! +&mi#ai a'i !a&a, a,a! l*ih.

Pasien le1kemia bisa mendapatkan kemoterapi dengan berbagai cara4

• M*lal!i m!l!,

• D*#a# !#,i+a# la#!# +* "*m!l!h a'ah ali+ (a,a! i#,'a*#a).

• M*lal!i +a,*,*' (,a!# +*0il $a# 4l*+i*l) $a# i,*m"a,+a# i alam

"*m!l!h a'ah ali+ *a'% *'i#+ali i aa aia# a,a P*'a;a, a+a#m*#$!#,i++a# &a, +* alam +a,*,*'% !#,!+ m*#hi#a'i !#,i+a# $a#

*'!la# +ali. Ca'a i#i a+a# m*#!'a#i 'aa ,ia+ #$ama# a#a,a!

0**'a "aa "*m!l!h a'ah ali++!li,.

• D*#a# !#,i+a# la#!# +* 0ai'a# 0*'*'&"i#al /i+a ahli "a,&l&i

m*#*m!+a# *l-*l l*!+*mia alam 0ai'a# $a# m*#ii '!a# i &,a+ a#

!m!m ,!la# *la+a#% &+,*' ia m*m*'i#,ah+a# +*m&,*'a"i

i#,'a,*+al. D&+,*' a+a# m*#$!#,i++a# &a, la#!# +* alam 0ai'a#

0*'*'&"i#al. M*,&* i#i i!#a+a# +a'*#a &a, $a# i*'i+a# m*lal!i

!#,i+a# I a,a! imi#!m *'i#+ali ,ia+ m*#0a"ai *l-*l i &,a+ a#

!m!m ,!la# *la+a#.

!erdapat tiga fase pelaksanaan kemoterapi 4

9. a+ Fa* I#!+i Dim!lai 3-@ mi#! *,*lah ia#&a i,*a++a#.

Paa 4a* i#i i*'i+a# ,*'a"i +&',i+&,'*'&i ("'*#i)% i#0'i,i# a# L-

a"a'ai#a*. Fa* i#!+i i#$a,a+a# *hail /i+a ,a#a-,a#a "*#$a+i,

*'+!'a# a,a! ,ia+ aa a# alam !m!m ,!la# i,*m!+a# /!mlah *l

m!a +!'a# a'i 12.

9. b+ Fa* P'&4ila+i Si,*m a'a4 "!a,Paa 4a* i#i i*'i+a# ,*'a"i

m*,h&,'*a,*% 0$,a'ai#* a# h$'&0&,i m*la!i i#,'a,h*0al !#,!+

m*#0*ah i#i *l l*!+*mia +* &,a+. T*'a"i i''aiai +'a#ial ila+!+a#

ha#$a "aa "ai*# l*!+*mia $a# m*#alami a#!a# i,*m a'a4 "!a,.


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9. c+ K&liai "aa 4a* i#i +&mi#ai "*#&a,a# ila+!+a#

!#!,+ m*m"*',aha#+a# '*mii a# m*#!'a#i /!mlah *l-*l l*!+*mia

$a# *'*a' alam ,!!h. S*0a'a *'+ala% mi#!a# a,a! !la#a#ila+!+a# "*m*'i+aa# a'ah l*#+a" !#,!+ m*#ilai '*" !m!m

,!la# ,*'haa" "*#&a,a#. Ji+a ,*'/ai !"'*i !m!m ,!la#% ma+a

"*#&a,a# ih*#,i+a# *m*#,a'a a,a! &i &a, i+!'a#i.

9. !erapi %iologi

O'a# *#a# /*#i "*#$a+i, l*!+*mia ,*',*#,! m*#/ala#i ,*'a"i i&l&i !#,!+

m*#i#+a,+a# a$a ,aha# alami ,!!h ,*'haa" +a#+*'. T*'a"i i#i i*'i+a#

m*lal!i !#,i+a# i alam "*m!l!h a'ah ali+. Bai "ai*# *#a# l*!+*mialim4&i,i+ +'i% /*#i ,*'a"i i&l&i $a# i!#a+a# aalah a#,i&i m&+lal

$a# a+a# m*#i+a,+a# i'i "aa *l-*l l*!+*mia. T*'a"i i#i m*m!#+i#+a#

i,*m +*+*ala# !#,!+ m*m!#!h *l-*l l*!+*mia i alam a'ah a# !m!m

,!la#. Bai "*#*'i,a *#a# l*!+*mia m$*l&i +'i% ,*'a"i i&l&i $a#

i!#a+a# aalah aha# alami *'#ama i#,*'4*' !#,!+ m*m"*'lama,

"*',!m!ha# *l-*l l*!+*mia.

9. !erapi "adiasi

T*'a"i Raiai (/!a i*!, *aai 'ai&,*'a"i) m*#!#a+a# i#a' *'*#*'i

,i#i !#,!+ m*m!#!h *l-*l l*!+*mia. Bai *aia# *a' "ai*#% *!ah

m*i# $a# *a' a+a# m*#a'ah+a# 'aiai "aa lim"a% &,a+% a,a! aia# lai#

alam ,!!h ,*m"a, m*#!m"!+#$a *l-*l l*!+*mia i#i. B**'a"a "ai*#

m*#a"a,+a# 'aiai $a# ia'ah+a# +* *l!'!h ,!!h. (I'aiai *l!'!h ,!!h

iaa#$a i*'i+a# **l!m ,'a#"la#,ai !m!m ,!la#.)

9. !ransplantasi $el #nd1k ($tem Cell)

B**'a"a "ai*# l*!+*mia m*#/ala#i ,'a#"la#,ai *l i#!+ (,*m 0*ll).

T'a#"la#,ai *l i#!+ m*m!#+i#+a# "ai*# i&a,i *#a# &i &a, $a#

,i#i% 'aiai% a,a! +*!a#$a. D&i ,i#i i#i a+a# m*#ha#0!'+a# *l-*l

l*!+*mia *+ali! *l-*l a'ah #&'mal alam !m!m ,!la#. K*m!ia#% "ai*#

a+a# m*#a"a,+a# *l-*l i#!+ (,*m 0*ll) $a# *ha, m*lal!i ,a!# 4l*+i*l

$a# i"aa# i "*m!l!h a'ah ali+ *a' i a*'ah aa a,a! l*h*'. S*l-*l

a'ah $a# a'! a+a# ,!m!h a'i *l-*l i#!+ (,*m 0*ll) hail ,'a#"la#,ai i#i.

S*,*lah ,'a#"la#,ai *l i#!+ (,*m 0*ll)% "ai*# iaa#$a ha'! m*#i#a" i

'!mah a+i, *lama **'a"a mi#!. Tim +**ha,a# a+a# m*li#!#i "ai*# a'i


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i#4*+i am"ai *l-*l i#!+ (,*m 0*ll) hail ,'a#"la#,ai m!lai m*#hail+a#

*l-*l a'ah "!,ih alam /!mlah $a# m*maai.

%A% ###

A$A' ,&P&"A;A!A'

6+3 Pengkajian

P*#+a/ia# aalah aa' !,ama a'i "'&* +*"*'a;a,a#% "*#!m"!la# a,a $a#

a+!'a, a# i,*ma,i a+a# m*ma#,! "*#*#,!a# ,a,! +**ha,a# a# "&la

"*',aha#a# +li*#% m*#i*#,i4i+ai +*+!a,a# a# +*!,!ha# +li*# *',a

m*'!m!+a# ia#&a +*"*'a;a,a#. (B!i A##a K*lia,% 9


32/41

P*#+a/ia# "aa l*!+*mia m*li"!,i 8

a. Ri;a$a, "*#$a+i,

. Ka/i aa#$a ,a#a-,a#a a#*mia 8

• P!0a,

• K*l*maha#

• S*a+

• Na4a 0*"a,

0. Ka/i aa#$a ,a#a-,a#a l*!0&"*#ia

• D*mam

• I#4*+i

. Ka/i aa#$a ,a#a-,a#a ,'&m&i,&"*#ia 8

• P,*0hia*

• P!'"!'a

• P*'a'aha# m*m'a# m!+&a

*.Ka/i aa#$a ,a#a-,a#a i#ai *+,'a m*!l&la 8

• Lim4a*#&"a,i

• H*"a,&m*ali

• S"l*#&m*ali

4.Ka/i aa#$a "*m*a'a# ,*,i

.Ka/i aa#$a 8

• H*ma,!'i

• Hi"*',*#i


33/41

• Gaal i#/al

• I#4lamai i*+i,a' '*0,al

• N$*'i

6+2 Diagnosa ,epera


34/41

"asional 8 !#,!+ m*mi#imal+a# ,*'"a"a'#$a P a'i !m*' i#4*+i

• A#/!'+a# *m!a "*#!#/!# a# ,a44 '!mah a+i, !#,!+ m*#!#a+a#

,*+#i+ m*#0!0i ,a#a# *#a# ai+.

"asional 8 !#,!+ m*mi#imal+a# "a/a#a# "aa &'a#im* i#4*+,i4.

• G!#a+a# ,*+#i+ a*",i+ $a# 0*'ma, !#,!+ *m!a "'&*!' i#ai*

"asional 8 !#,!+ m*#0*ah +,ami#ai ila#m*#!'!#+a# '*i+& i#4*+i

•

Eal!ai +*aaa# a#a+ ,*'haa" ,*m"a,-,*m"a, m!#0!l#$a i#4*+i *"*',i,*m"a,

"*#!!+a# /a'!m% !l*'ai m!+&a% a# maalah ii.

"asional 8 !#,!+ i#,*'*#i i#i "*#a#a#a# i#4*+i.

• I#"*+i m*m'a# m!+&a m!l!,. B*'ih+a# m!l!, *#a# ai+

"asional 8 'a m!l!, aalah m*i!m $a# ai+ !#,!+ "*',!m!ha#

&'a#im

• B*'i+a# "*'i&* i,i'aha, ,a#"a a#!a#

"asional 8 m*#amah *#*'i !#,!+ "*#$*m!ha# a# '**#*'ai *l!l*'.

• B*'i+a# i*, l*#+a" #!,'ii *!ai !ia.

"asional 8 !#,!+ m*#!+!# "*',aha#a# alami ,!!h.

• B*'i+a# a#,ii&,i+ *!ai +*,*#,!a#

"asional 8 i*'i+a# *aai "'&4ila+,i+ a,a! m*#&a,i i#4*+i +h!!.

9. I#,&l*'a#i a+,ii,a *'h!!#a# *#a# +*l*maha# a+ia, a#*mia

!1j1an 8 ,*'/ai "*#i#+a,a# ,&l*'a#i a+,i4i,a

#nter=ensi 8

• Eal!ai la"&'a# +*l*maha#% "*'ha,i+a# +*,ia+mam"!a# !#,!+

*'"a',ii"ai alam a+,i4i,a *ha'i-ha'i.


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"asional 8 m*#*#,!+a# *'a/a, a# *4*+ +*,ia+mam"!a#.

• B*'i+a# li#+!#a# ,*#a# a# "*'l! i,i'aha, ,a#"a a#!a#"asional 8 m*#h*ma, *#*'i !#,!+ a+,i4i,a a# '**#*'ai *l!l*' a,a!

"*#$am!#a# /a'i#a#.

• Ka/i +*mam"!a# !#,!+ *'"a',ii"ai "aa a+,i4i,a $a# ii#i#+a# a,a!

i!,!h+a#.

"asional 8 m*#i*#,i4i+ai +*!,!ha# i#ii!al a# m*ma#,!

"*miliha# i#,*'*#i.

• B*'i+a# a#,!a# alam a+,i4i,a *ha'i-ha'i a# am!lai

"asional 8 m*ma+imal+a# *iaa# *#*'i !#,!+ ,!a "*'a;a,a# i'i

9. R*i+& ,*'haa" 0**'a"*'a'aha# $a# *'h!!#a# *#a# "*#!'!#a#

/!mlah ,'&m&i,

!1j1an 8 +li*# ,ia+ m*#!#/!++a# !+,i-!+,i "*'a'aha#

#nter=ensi 8

• G!#a+a# *m!a ,i#a+a# !#,!+ m*#0*ah "*'a'aha# +h!!#$a "aa

a*'ah *+im&i."asional 8 +a'*#a "*'a'aha# m*m"*'*'a, +ii a#a+ *#a# aa#$a

a#*mia.

• C*ah !l*'ai &'al a# '*0,al.

"asional 8 +a'*#a +!li, $a# l!+a 0*#*'!# !#,!+ *'a'ah.

• G!#a+a# /a'!m $a# +*0il "aa aa, m*la+!+a# i#/*+i.

"asional 8 !#,!+ m*#0*ah "*'a'aha#

• M*#!#a+a# i+a, ii $a# l!#a+ a# l*m!,

"asional 8 !#,!+ m*#0*ah "*'a'aha#

• La"&'+a# *,ia" ,a#a-,a#a "*'a'aha# (,*+a#a# a'ah m*#!'!#% *#$!,

#ai 0*"a,% a# "!0a,).

"asional 8 !#,!+ m*m*'i+a# i#,*'*#i i#i alam m*#a,ai "*'a'aha#.

• Hi#a'i &a,-&a, $a# m*#a#!# a"i'i#.


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"asional 8 +a'*#a a"i'i# m*m"*#a'!hi 4!#i ,'&m&i,.

• A/a'+a# &'a# ,!a a# a#a+ $a# l*ih *a' #,!+ m*#,'&l "*'a'aha#hi!#.

"asional 8 !#,!+ m*#0*ah "*'a'aha#.

. R*i+& ,i#i +*+!'a#a# &l!m* 0ai'a# *'h!!#a# *#a# m!al a# m!#,a

!1j1an 8 Tia+ ,*'/ai +*+!'a#a# &l!m* 0ai'a#

Pai*# ,ia+ m*#alami m!al a# m!#,ah

#nter=ensi 4

• B*'i+a# a#,i*m*,i+ a;al **l!m im!lai#$a +*m&,*'a"i

"asional 8 !#,!+ m*#0*ah m!al a# m!#,ah

• B*'i+a# a#,i*m*,i+ *0a'a ,*'a,!' "aa ;a+,! a# "'&'am +*m&,*'a"i

"asional 8 !#,!+ m*#0*ah *"i&* *'!la#

• Ka/i '*" P ,*'haa" a#,i *m*,i0.

"asional 8 +a'*#a ,ia+ aa &a, a#,i*m*,i+ $a# *0a'a !m!m *'hail.

• Hi#a'i m*m*'i+a# ma+a#a# $a# *'a'&ma m*#$*#a,

"asional 8 a! $a# m*#$*#a, a"a, m*#im!l+a# m!al a# m!#,ah

•

A#/!'+a# ma+a# alam "&'i +*0il ,a"i *'i#

"asional 8 +a'*#a /!mlah +*0il iaa#$a i,&l*'a#i *#a# ai+

• B*'i+a# 0ai'a# i#,'a*#a *!ai +*,*#,!a#

"asional 4 !#,!+ m*m"*',aha#+a# hi'ai

9. N$*'i $a# *'h!!#a# *#a# *4*+ 4ii&l&i a'i l*!+*mia


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!1j1an 8 "ai*# ,ia+ m*#alami #$*'i a,a! #$*'i m*#!'!# am"ai ,i#+a, $a#

a"a,

i,*'ima a#a+

#nter=ensi 4

• M*#+a/i ,i#+a, #$*'i *#a# +ala 6 am"ai 1

"asional 8 i#4&'mai m*m*'i+a# a,a aa' !#,!+ m*#*al!ai +*!,!ha# a,a!

+**4*+,i4a# i#,*'*#i

• Ji+a m!#+i#% !#a+a# "'&*!'-"'&*!' (mial "*ma#,a!a# !h! #

i#ai4% ala,

a+* *#a

"asional 8 !#,!+ m*mi#imal+a# 'aa ,ia+ ama#

• Eal!ai *4*+,i4i,a "*#hila# #$*'i *#a# *'a/a, +*aa'a# a# *ai

"asional 8 !#,!+ m*#*#,!+a# +*!,!ha# "*'!aha# &i. a+,!

"*m*'ia# a,a! &a,

• La+!+a# ,*+#i+ "*#!'a#a# #$*'i # 4a'ma+&l&i $a# ,*"a,

"asional 8 *aai a#al*,i+ ,amaha#

• B*'i+a# &a,-&a, a#,i #$*'i *0a'a ,*'a,!'

"asional 8 !#,!+ m*#0*ah +am!h#$a #$*'i

9. K*'!a+a# i#,*'i,a +!li, *'h!!#a# *#a# "*m*'ia# a*#+*m&,*'a"i% 'ai&,*'a"i% im&ili,a.

!1j1an 8 "ai*# m*m"*',aha#+a# i#,*'i,a +!li,

#nter=ensi 8

• B*'i+a# "*'a;a,a# +!li, $a# 0*ma,% ,*'!,ama i alam m!l!, a# a*'ah

"*'ia#al

"asional 8 +a'*#a a'*a i#i 0*#*'!# m*#alami !l*'ai

• Uah "&ii *#a# *'i#


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"asional 8 !#,!+ m*'a#a# i'+!lai a# m*#0*ah ,*+a#a# "aa +!li,

• Ma#i+a# *#a# ai' ha#a, a# a!# 'i#a#

"asional 8 m*m"*',aha#+a# +**'iha# ,a#"a m*#i'i,ai +!li,

• Ka/i +!li, $a# +*'i# ,*'haa" *4*+ am"i# ,*'a"i +a#+*'

"asional 8 *4*+ +*m*'aha# a,a! +!li, +*'i# a# "'!'i,!% !l*'ai a"a, ,*'/ai

alam a'*a 'aiai "aa **'a"a a*# +*m&,*'a"i

• A#/!'+a# "ai*# !#,!+ ,ia+ m*#a'!+ a# m*#*"!+ +!li, $a# +*'i#.

"asional 8 m*ma#,! m*#0*ah 4'i+i a,a! ,'a!ma +!li,.

• D&' ma!+a# +al&'i "'&,*i# $a# a*+!a,

"asional 8 !#,!+ m*#0*ah +**ima#a# #i,'&*# $a# #*a,i4

• Pilih "a+aia# $a# la' a# l*m!, ia,a a'*a $a# ,*'aiai

"asional 8 !#,!+ m*mi#imal+a# i'i,ai ,amaha#

9. Ga#!a# 0i,'a ,!!h *'h!!#a# *#a# al&"*ia a,a! "*'!aha# 0*"a,

"aa

"*#am"ila#

!1j1an 8 "ai*# a,a! +*l!a'a m*#!#/!++a# "*'ila+! +&"i# "&i,i4

#nter=ensi 4

• D&' a#a+ !#,!+ m*milih ;i (a#a+ "*'*m"!a#) $a# *'!"a a$a a#

;a'#a 'am!, a#a+ **l!m 'am!, m!lai ',&+

"asional 8 !#,!+ m*ma#,! m*#*ma#+a# "*#$*!aia# 'am!, ,*'haa"

+*',&+a# 'am!,

• B*'i+a# "*#!,!" +*"ala $a# a*+!a, *lama "*ma/a#a# "aa i#a'

ma,aha'i% a#i# a,a! i#i#

"asional 8 +a'*#a hila##$a "*'li#!#a# 'am!,

• A#/!'+a# !#,!+ m*#/aa aa' 'am!, $a# ,i"i i,! ,*,a" *'ih% "*#*+

a# hal!

"asional 8 !#,!+ m*#$ama'+a# +*&,a+a# "a'ial


39/41

• J*la+a# ah;a 'am!, m!lai ,!m!h alam : hi#a @ !la# a#

m!#+i# ;a'#a a,a! ,*+,!'#$a aa+ *'*a.

"asional 8 !#,!+ m*#$ia"+a# a#a+ a# +*l!a'a ,*'haa" "*'!aha# "*#am"ila#

'am!, a'!

• D&' h$i*#*% *'a#% a# ala, ala, $a# *!ai *#a# /*#i +*lami# %

mial#$a ;i% +a'4% ,&"i% ,a,a 'ia% a# "a+aia# $a# m*#a'i+

"asional 8 !#,!+ m*#i#+a,+a# "*#am"ila#.


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%A% 35

P&'!P

7+3 ,esimp1lan

L*!+*mia aalah #*&"lama a+!, a,a! +'i a'i *l-*l "*m*#,!+ a'ah alam

!m!m ,!la# a# lim4a #ai (R***% 5669).

P*#!li *'"*#a"a, ah;a l*!+*mia aalah !a,! "*#$a+i, $a# i*a+a# &l*h

"'&li4*'ai a#&'mal a'i *l-*l l*!+&i, $a# m*#$*a+a# ,*'/ai#$a +a#+*'

"aa ala, "*m*#,!+ a'ah.

L*!+*mia a+!, a# +'i m*'!"a+a# !a,! *#,!+ +*a#aa# a,a! mali#a $a#

m!#0!l a'i "*'a#$a+a# +lal *l-*l "*m*#,!+ *l a'ah $a# ,ia+ ,*'+,'&l

m*+a#im* +,'&l *l!l*' #&'mal m!#+i# ,ia+ *+*'/a *#a# ai+ a+ia,

aa#$a "*'!aha# "aa +&* *#*,i+ $a# *ha'!#$a *',a#!# /a;a a,a

"*#a,!'a# "*',!m!ha# *l a# i4*'*#iai.

S*l-*l l*!+*mia m*#/ala#i ;a+,! a!' !la# $a# l*ih lama, ia#i#+a# *l

#&'mal. P'&* "*ma,a#a# a,a! ma,!'ai *'/ala# ,ia+ l*#+a" a# lama, *',a

*',aha# hi!" l*ih lama ia#i#+a# *l #&'mal.

P*#$*a l*!+*mia aa **'a"a 4a+,&'% ia#,a'a#$a8 *#*,i+% a!a'a +a#!#%

4a+,&' li#+!#a#% i'!% aha# +imia% a# &a,-&a,a#.

Klai4i+ai l*!+imia ,*'i'i a'i L*!+imia Mi*l&*#! A+!,% L*!+imia

Mi*l&*#! K'i% L*!+*mia Lim4&i,i+ A+!,% L*!+*mia Lim4&i,i+ K'i+.

Ma#i4*,ai +li#i+ $a# *'i# i/!m"ai "aa "*#$a+i, l*!+*mia aalah *aai

*'i+!,8

9. Pil*+ ,ia+ *m!h-*m!h a+i, +*"ala.

5. P!0a,% l*!% m!ah ,*',im!lai% M*'aa l*mah a,a! l*,ih.

:. D*mam% +*'i#a, malam a# a#&'*ia

3. B*'a, aa# m*#!'!#

1. P,*0hia*% m*ma' ,a#"a *a% M!ah *'a'ah a# l*am (!i *'a'ah%

*'0a+ +*!#!a# i +!li,% a,a! i#,i+-i#,i+ m*'ah +*0il i a;ah +!li,)

@. N$*'i "aa ,!la# a# "*'*#ia#


41/41

?. N$*'i a&m*#% P*m*#+a+a# a,a! 'aa ,ia+ #$ama# i "*'!, (a+ia,

"*m*a'a# lim"a).

P*#,ala+a#a# "aa "*#$a+i# l*!+*mia m*li"!,i8 +*m&,*'a"i% ,*'a"i i&l&i% ,*'a"i

'aiai% a# ,'a#"la#,ai *l i#!+.

U#,!+ m*#hi#a'i l*!+imia ha'! i0*ah *i#i m!#+i#% a# +*,i+a !ah aa

*/ala-*/ala **'a "*'i+a+a# +* &+,*'.

makalah kanker darah

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