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放线菌素D作为复发或耐药性淋巴瘤犬的挽救疗法:49例(1999 - 2006年)

Actinomycin D as rescue therapy in dogs with relapsed or resistant lymphoma: 49 cases (1999--2006).

作者信息

Bannink Erin O, Sauerbrey Michele L, Mullins Marie N, Hauptman Joe G, Obradovich Joyce E

机构信息

Animal Cancer and Imaging Center, 8560 Canton Center Rd, Canton, MI 48187, USA.

出版信息

J Am Vet Med Assoc. 2008 Aug 1;233(3):446-51. doi: 10.2460/javma.233.3.446.

Abstract

OBJECTIVE

To evaluate response rate and disease-free interval in dogs with relapsed or resistant lymphoma treated with actinomycin D, determine hematologic toxicoses, and identify prognostic factors associated with response to treatment.

DESIGN

Retrospective case series.

ANIMALS

49 dogs with relapsed or resistant lymphoma.

PROCEDURES

Medical records were reviewed for information regarding signalment, physical examination findings, results of diagnostic testing, substage, previous chemotherapy, previous treatment with prednisone, actinomycin D dosage, number of doses administered, response, disease-free interval, and results of CBCs performed after treatment.

RESULTS

Actinomycin D was administered at a median dosage of 0.68 mg/m2 (range, 0.46 to 0.72 mg/m2), IV, every 3 weeks for 5 treatments or until disease progression. Twenty-six (53%) dogs received prednisone concurrently. Twenty (41%) dogs had a complete remission, and median disease-free interval in these dogs was 129 days. Thrombocytopenia was the most common hematologic toxicosis (n = 22 [45%]). Concurrent prednisone administration, a shorter duration of first remission, and an increased number of previous chemotherapy agents were significantly associated with a lower likelihood of responding to actinomycin D treatment. Concurrent prednisone administration and an increased number of previous chemotherapy agents were significantly associated with a shorter disease-free interval.

CONCLUSION AND CLINICAL RELEVANCE

Results suggested that administration of actinomycin D as a single agent was effective for rescue chemotherapy of dogs with relapsed or resistant lymphoma and that treatment was well tolerated, although mild thrombocytopenia developed commonly.

摘要

目的

评估用放线菌素D治疗复发或难治性淋巴瘤犬的缓解率和无病间期,确定血液学毒性,并识别与治疗反应相关的预后因素。

设计

回顾性病例系列。

动物

49只复发或难治性淋巴瘤犬。

步骤

查阅病历以获取有关特征、体格检查结果、诊断性检测结果、亚分期、先前化疗、先前泼尼松治疗、放线菌素D剂量、给药剂量数、反应、无病间期以及治疗后进行的全血细胞计数结果等信息。

结果

放线菌素D的中位剂量为0.68mg/m²(范围为0.46至0.72mg/m²),静脉注射,每3周1次,共治疗5次或直至疾病进展。26只(占53%)犬同时接受泼尼松治疗。20只(占41%)犬完全缓解,这些犬的中位无病间期为129天。血小板减少是最常见的血液学毒性(n = 22 [45%])。同时给予泼尼松、首次缓解期较短以及先前化疗药物数量增加与对放线菌素D治疗反应的可能性较低显著相关。同时给予泼尼松和先前化疗药物数量增加与较短的无病间期显著相关。

结论及临床意义

结果表明,放线菌素D单药治疗对复发或难治性淋巴瘤犬的挽救化疗有效,且治疗耐受性良好,尽管常见轻度血小板减少。

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