Rassnick Kenneth M, Bailey Dennis B, Malone Erin K, Flory Andrea B, Kiselow Michael A, Intile Joanne L
Veterinary Medical Center of Central New York, East Syracuse, NY.
J Am Anim Hosp Assoc. 2014 May-Jun;50(3):167-73. doi: 10.5326/JAAHA-MS-6020. Epub 2014 Mar 21.
This retrospective study describes toxicity associated with a protocol of lomustine (CCNU) and cyclophosphamide (CTX) in dogs with lymphoma. CCNU was administered per os (PO) at a targeted dosage of 60 mg/m(2) body surface area on day 0, CTX was administered PO at a targeted dosage of 250 mg/m(2) divided over days 0 through 4, and all dogs received prophylactic antibiotics. Ninety treatments were given to the 57 dogs included in the study. Neutropenia was the principal toxic effect, and the overall frequency of grade 4 neutropenia after the first treatment of CCNU/CTX was 30% (95% confidence interval, 19-43%). The mean body weight of dogs with grade 4 neutropenia (19.7 kg ± 13.4 kg) was significantly less than the mean body weight of dogs that did not develop grade 4 neutropenia (31.7 kg ± 12.4 kg; P = .005). One dog (3%) developed hematologic changes suggestive of hepatotoxicity. No dogs had evidence of either renal toxicity or hemorrhagic cystitis. Adverse gastrointestinal effects were uncommon. On the basis of the findings reported herein, a dose of 60 mg/m(2) of CCNU combined with 250 mg/m(2) of CTX (divided over 5 days) q 4 wk is tolerable in tumor-bearing dogs.
这项回顾性研究描述了洛莫司汀(CCNU)和环磷酰胺(CTX)联合方案用于犬淋巴瘤时的毒性反应。CCNU于第0天经口(PO)给药,目标剂量为60mg/m²体表面积,CTX于第0天至第4天经口给药,目标剂量为250mg/m²,分5天给予,所有犬均接受预防性抗生素治疗。本研究纳入的57只犬共接受了90次治疗。中性粒细胞减少是主要的毒性反应,首次给予CCNU/CTX治疗后4级中性粒细胞减少的总体发生率为30%(95%置信区间,19 - 43%)。发生4级中性粒细胞减少的犬的平均体重(19.7kg ± 13.4kg)显著低于未发生4级中性粒细胞减少的犬的平均体重(31.7kg ± 12.4kg;P = 0.005)。1只犬(3%)出现提示肝毒性的血液学变化。没有犬有肾毒性或出血性膀胱炎的证据。不良胃肠道反应不常见。基于本文报道的研究结果,对于荷瘤犬,每4周给予60mg/m²的CCNU联合250mg/m²的CTX(分5天给予)是可耐受的。