O'Keefe D A, Schaeffer D J
Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61801.
J Vet Intern Med. 1992 Sep-Oct;6(5):276-82. doi: 10.1111/j.1939-1676.1992.tb00352.x.
The hematologic toxicity of doxorubicin, 30 mg/m2 body surface area (BSA) every 21 days to a cumulative dose of 300 mg/m2, was evaluated in six cats. Complete blood and platelet counts were performed daily during the first treatment cycle. They were monitored before treatment for all remaining cycles, and at the average neutrophil nadir (day 8) starting with cycle 4. Significant poikilocytosis developed after the first treatment and remained throughout the study, although anemia did not occur. No other red blood cell abnormalities were seen. Platelet counts remained within the reference range throughout the first treatment cycle, but mild thrombocytopenia (88,000-288,000/uL) was found in 11.3% of subsequent complete blood counts (CBCs). Thrombocytosis was seen in 30.9% of CBCs. Neutropenia did not occur during the first treatment cycle although neutrophil counts did decrease, with the nadir occurring between days 8 and 11. All neutrophil counts returned to pretreatment values by day 14. Neutropenia was documented after 14 of 46 (30.4%) doxorubicin treatments, and was associated with fever in 5 cats (10.9%). All fevers responded to oral antibiotic therapy. Neutropenia that lasted more than 14 days developed in two cats, necessitating dosage reduction to 25 mg/m2 BSA. At the dose used in this study, doxorubicin administration was associated with acceptable hematologic toxicosis in most cats.
对6只猫评估了阿霉素的血液学毒性，剂量为每21天30 mg/m²体表面积（BSA），累积剂量达300 mg/m²。在第一个治疗周期期间每日进行全血细胞和血小板计数。在所有剩余周期治疗前进行监测，从第4周期开始在平均中性粒细胞最低点（第8天）进行监测。首次治疗后出现显著的异形红细胞增多症，并在整个研究过程中持续存在，尽管未发生贫血。未观察到其他红细胞异常。在第一个治疗周期期间血小板计数保持在参考范围内，但在随后11.3%的全血细胞计数（CBC）中发现轻度血小板减少（88,000 - 288,000/μL）。在30.9%的CBC中观察到血小板增多。在第一个治疗周期期间未发生中性粒细胞减少，尽管中性粒细胞计数确实下降，最低点出现在第8天至第11天之间。到第14天所有中性粒细胞计数恢复到治疗前值。在46次阿霉素治疗中的14次（30.4%）后记录到中性粒细胞减少，5只猫（10.9%）出现发热。所有发热对口服抗生素治疗均有反应。两只猫出现持续超过14天的中性粒细胞减少，需要将剂量减至25 mg/m² BSA。在本研究使用的剂量下，大多数猫使用阿霉素与可接受的血液学中毒相关。
