犬 B 细胞慢性淋巴细胞白血病的临床转归和预后因素：一项回顾性研究。

Clinical outcome and prognostic factors in dogs with B-cell chronic lymphocytic leukemia: A retrospective study.

机构信息

Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.

Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA.

出版信息

J Vet Intern Med. 2021 Jul;35(4):1918-1928. doi: 10.1111/jvim.16160. Epub 2021 May 17.

DOI:10.1111/jvim.16160

PMID:33998726

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8295712/

Abstract

BACKGROUND

B-cell chronic lymphocytic leukemia (BCLL) in dogs generally is considered an indolent disease, but previous studies indicate a wide range in survival times.

OBJECTIVES

We hypothesized that BCLL has a heterogeneous clinical course, similar to chronic lymphocytic leukemia in humans. We aimed to assess presentation and outcome in dogs with BCLL and evaluate the prognostic relevance of clinical and flow cytometric factors.

ANIMALS

One hundred and twenty-one dogs with BCLL diagnosed by flow cytometry. Three breed groups were represented: small breed dogs (n = 55) because of increased risk of BCLL; Boxers (n = 33) because of preferential use of unmutated immunoglobulin genes; and other breeds (n = 33).

METHODS

Retrospective study reviewing signalment, clinicopathologic data, physical examination findings, treatment, and survival of dogs with BCLL. Cellular proliferation, determined by the percentage of Ki67-expressing CD21+ B-cells by flow cytometry, was measured in 39 of 121 cases. Clinical and laboratory variables were evaluated for association with survival.

RESULTS

The median survival time (MST) for all cases was 300 days (range, 1-1644 days). Boxers had significantly shorter survival (MST, 178 days) than non-Boxers (MST, 423 days; P < .0001), and no significant survival difference was found between small breeds and other non-Boxer breeds. Cases with high Ki67 (>40% Ki67-expressing B-cells) had significantly shorter survival (MST, 173 days) than did cases with <40% Ki67 (MST undetermined; P = .03), regardless of breed. Cases with a high lymphocyte count (>60 000 lymphocytes/μL) or clinical signs at presentation had significantly shorter survival.

CONCLUSIONS AND CLINICAL IMPORTANCE

B-cell chronic lymphocytic leukemia had a variable clinical course and Boxer dogs and cases with high Ki67 had more aggressive disease.

摘要

背景

犬 B 细胞慢性淋巴细胞白血病（BCLL）通常被认为是一种惰性疾病，但先前的研究表明其生存时间差异很大。

目的

我们假设 BCLL 具有异质性的临床病程，类似于人类的慢性淋巴细胞白血病。我们旨在评估犬 BCLL 的临床表现和结局，并评估临床和流式细胞术因素的预后相关性。

动物

121 只通过流式细胞术诊断为 BCLL 的犬。代表了 3 个品种组：由于 BCLL 风险增加而选择的小型犬（n=55）；由于优先使用未突变免疫球蛋白基因而选择的拳师犬（n=33）；以及其他品种（n=33）。

方法

回顾性研究，评估了犬 BCLL 的发病年龄、临床病理数据、体格检查结果、治疗和生存情况。流式细胞术检测 CD21+ B 细胞中 Ki67 表达的百分比，以评估细胞增殖，在 121 例病例中有 39 例进行了测量。评估了临床和实验室变量与生存的相关性。

结果

所有病例的中位生存时间（MST）为 300 天（范围 1-1644 天）。与非拳师犬（MST 423 天；P<0.0001）相比，拳师犬的生存时间明显更短（MST 178 天），而小型犬与其他非拳师犬品种之间的生存差异无统计学意义。Ki67 高（>40% Ki67 表达的 B 细胞）的病例的生存时间明显更短（MST 173 天），而 Ki67 低（MST 未确定；P=0.03）的病例的生存时间更长，无论品种如何。淋巴细胞计数高（>60000 个/μL）或有临床表现的病例的生存时间明显更短。