Department of Small Animal Clinical Science, University of Liverpool, Liverpool, UK.
Southfields Veterinary Specialists, Laindon, UK.
J Feline Med Surg. 2021 Aug;23(8):722-729. doi: 10.1177/1098612X20972066. Epub 2020 Nov 12.
The aim of this study was to assess the efficacy and tolerability of lomustine, methotrexate and cytarabine chemotherapy as rescue treatment for feline lymphoma.
The medical records of 13 cats treated with lomustine, methotrexate and cytarabine for relapsed high-grade feline lymphoma, at a single institution between 2013 and 2018, were examined. All anatomical types were included. Data were analysed using descriptive statistics.
Nine cats received all three drugs and four cats received only two drugs owing to progressive disease. In cats that received (or in which there was intention to treat with) all three drugs, 6/13 (46%) demonstrated a complete or partial response to chemotherapy. Treatment was generally well tolerated, although two cats experienced Veterinary Comparative Oncology Group (VCOG) grade 3 neutropenia and one cat experienced VCOG grade 3 thrombocytopenia. The median progression-free survival was 61 days (range 16-721 days).
CHOP-(cyclophosphamide, doxorubicin, vincristine, prednisolone) and COP-based protocols are established first-line chemotherapy for feline lymphoma, but standard rescue protocols are lacking. Lomustine has become a popular single-agent option, but prolonged or cumulative myelosuppression can result in treatment delays, risking relapse. Therefore, a multidrug lomustine-based protocol may be advantageous, and, from first principles, should also better overcome resistance. This study suggests that lomustine, methotrexate and cytarabine may represent an efficacious and well-tolerated protocol for feline lymphoma rescue.
本研究旨在评估洛莫司汀、甲氨蝶呤和阿糖胞苷化疗作为猫复发性高级别淋巴瘤的挽救治疗的疗效和耐受性。
检查了 2013 年至 2018 年间在一家机构接受洛莫司汀、甲氨蝶呤和阿糖胞苷治疗复发性高级别猫淋巴瘤的 13 只猫的病历。所有解剖类型均包括在内。使用描述性统计分析数据。
9 只猫接受了所有三种药物，4 只猫由于疾病进展仅接受了两种药物。在接受（或打算用）所有三种药物治疗的猫中，6/13（46%）对化疗有完全或部分反应。治疗通常耐受性良好，尽管有 2 只猫出现兽医比较肿瘤学组（VCOG）3 级中性粒细胞减少症，1 只猫出现 VCOG 3 级血小板减少症。无进展生存期的中位数为 61 天（范围 16-721 天）。
CHOP（环磷酰胺、多柔比星、长春新碱、泼尼松）和 COP 方案是猫淋巴瘤的标准一线化疗方案，但缺乏标准的挽救方案。洛莫司汀已成为一种流行的单药选择，但长期或累积性骨髓抑制会导致治疗延迟，从而增加复发风险。因此，多药洛莫司汀方案可能更有效，并且从原理上讲，也应该更好地克服耐药性。本研究表明，洛莫司汀、甲氨蝶呤和阿糖胞苷可能代表一种治疗猫淋巴瘤挽救的有效且耐受性良好的方案。
