Al-Nadaf Sami, Rebhun Robert B, Curran Kaitlin M, Venable Rachel O, Skorupski Katherine A, Willcox Jennifer L, Burton Jenna H
William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.
BMC Vet Res. 2018 Nov 20;14(1):356. doi: 10.1186/s12917-018-1688-5.
A doxorubicin (DOX)-based chemotherapy protocol, CHOP, is the most effective treatment for canine high-grade B-cell lymphoma; however, the cost and time requirements associated with this protocol are not feasible for many pet owners. An alternative treatment option is the use of DOX, the most effective drug, in combination with prednisone. Prior studies with single-agent DOX included dogs with T-cell lymphoma, a known negative prognostic factor, which may have resulted in shorter reported survival times than if dogs with B-cell lymphoma were analyzed separately. The purpose of this study was to evaluate the outcome of dogs with high-grade B-cell lymphoma when treated with DOX and prednisone with or without L-asparaginase (L-ASP). Identification of prognostic factors was of secondary interest.
Thirty-three dogs were included in the study; 31 dogs were evaluable for response with an overall response rate of 84%. The median progression free survival (PFS) and overall survival (OS) were 147 days and 182 days, respectively. The one-year survival fraction was 23%. No variable other than protocol completion was found to be significant for either PFS or OS including historical prognostic factors such as substage, thrombocytopenia, and body weight.
Dogs with high-grade B-cell lymphoma treated with DOX and prednisone with or without L-ASP have similar response rates, PFS, and OS to prior studies that did not differentiate between lymphoma immunophenotype. This protocol is not a replacement for CHOP; however, it is an alternative if time and cost are factors, while providing therapeutic benefit greater than prednisone alone.
基于阿霉素(DOX)的化疗方案CHOP是犬高等级B细胞淋巴瘤最有效的治疗方法;然而,该方案的成本和时间要求对许多宠物主人来说并不可行。另一种治疗选择是使用最有效的药物DOX联合泼尼松。先前使用单药DOX的研究纳入了患有T细胞淋巴瘤的犬,这是一个已知的不良预后因素,这可能导致报告的生存时间比单独分析患有B细胞淋巴瘤的犬更短。本研究的目的是评估高等级B细胞淋巴瘤犬在接受DOX和泼尼松治疗时加或不加L-天冬酰胺酶(L-ASP)的治疗结果。识别预后因素是次要目的。
33只犬被纳入研究;31只犬可评估反应,总反应率为84%。无进展生存期(PFS)和总生存期(OS)的中位数分别为147天和182天。一年生存率为23%。除方案完成情况外,未发现其他变量对PFS或OS有显著影响,包括历史预后因素如分期、血小板减少和体重。
接受DOX和泼尼松治疗时加或不加L-ASP的高等级B细胞淋巴瘤犬,其反应率、PFS和OS与先前未区分淋巴瘤免疫表型的研究相似。该方案不能替代CHOP;然而,如果时间和成本是考虑因素,它是一种替代方案,同时提供比单独使用泼尼松更大的治疗益处。