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犬皮肤浆细胞增多症:21例(2005 - 2015年)

Canine Cutaneous Plasmacytosis: 21 Cases (2005-2015).

作者信息

Boostrom B O, Moore A S, DeRegis C J, Robat C, Freeman K, Thamm D H

机构信息

Colorado State University Flint Animal Cancer Center, Fort Collins, CO.

Veterinary Oncology Consultants, Lake Innes, NSW, Australia.

出版信息

J Vet Intern Med. 2017 Jul;31(4):1074-1080. doi: 10.1111/jvim.14729. Epub 2017 May 17.

Abstract

BACKGROUND

Cutaneous plasmacytosis (CP) is a syndrome of multiple cutaneous plasma cell tumors, in the absence of multiple myeloma. Although rare in both humans and dogs, treatment recommendations are usually extrapolated from multiple myeloma protocols. To date, no case series of CP have been described in the veterinary literature.

HYPOTHESIS/OBJECTIVES: To describe clinical presentation, determine treatment response rates and duration, and report overall survival of dogs with CP.

ANIMALS

Twenty-one client-owned dogs with CP.

METHODS

Medical records of 21 dogs with CP were reviewed. Diagnosis was based on histopathologic evaluation of at least 1 representative cutaneous or subcutaneous lesion in dogs with ≥3 lesions. Dogs with suspicion of multiple myeloma were excluded.

RESULTS

The most commonly affected breeds were the golden (5/21) and Labrador retriever (3/21). Fourteen of 21 dogs had >10 lesions, with some having >100. Lesions commonly were described as round, raised, pink-to-red, and variably alopecic or ulcerated. The most commonly used drug protocol was combined melphalan and prednisone, with an overall response rate (ORR) of 73.7% (14/19 dogs). Single-agent lomustine was associated with a similar ORR of 71.4% (5/7 dogs). For all treatments combined, the median progression-free interval after the first treatment was 153 days. The median survival time from the first treatment was 542 days.

CONCLUSIONS AND CLINICAL IMPORTANCE

Alkylating agents were effective in inducing remission of CP; corticosteroids, melphalan, and lomustine were the most commonly used drugs. Survival times were similar to those reported in dogs with multiple myeloma treated with alkylating agents.

摘要

背景

皮肤浆细胞增多症(CP)是一种多发性皮肤浆细胞瘤综合征,不存在多发性骨髓瘤。尽管在人类和犬类中都很罕见,但治疗建议通常是从多发性骨髓瘤方案推断而来。迄今为止,兽医文献中尚未描述过CP的病例系列。

假设/目标:描述临床表现,确定治疗反应率和持续时间,并报告患有CP的犬的总生存期。

动物

21只客户拥有的患有CP的犬。

方法

回顾了21只患有CP的犬的病历。诊断基于对至少1个代表性皮肤或皮下病变进行组织病理学评估,这些犬有≥3个病变。怀疑有多发性骨髓瘤的犬被排除。

结果

最常受影响的品种是金毛寻回犬(5/21)和拉布拉多寻回犬(3/21)。21只犬中有14只病变>10个,有些犬病变>100个。病变通常被描述为圆形、凸起、粉红色至红色,伴有不同程度的脱毛或溃疡。最常用的药物方案是美法仑和泼尼松联合使用,总缓解率(ORR)为73.7%(19只犬中的14只)。单药洛莫司汀的ORR相似,为71.4%(7只犬中的5只)。对于所有联合治疗,首次治疗后的中位无进展生存期为153天。首次治疗后的中位生存时间为542天。

结论及临床意义

烷化剂可有效诱导CP缓解;皮质类固醇、美法仑和洛莫司汀是最常用的药物。生存时间与用烷化剂治疗的患有多发性骨髓瘤的犬所报告的生存时间相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9fc/5508321/0f438fea2396/JVIM-31-1074-g001.jpg

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