Musser Margaret L, Curran Kaitlin M, Flesner Brian K, Johannes Chad M
College of Veterinary Medicine, Iowa State University, Ames, IA, United States.
Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, United States.
Front Vet Sci. 2021 Sep 22;8:718967. doi: 10.3389/fvets.2021.718967. eCollection 2021.
Chemotherapy overdoses (ODs) are severe complications that can occur following the use of antineoplastics. However, little is known about chemotherapy ODs in veterinary medicine. The goals of this retrospective study were to report the occurrence, type, and cause of known chemotherapy ODs in companion animal medicine. The American College of Veterinary Internal Medicine oncology and internal medicine listservs were solicited for chemotherapy OD cases in dogs and cats. An OD was defined as administration of a chemotherapy dose 10% higher than intended, or at a shorter interval than planned. Twelve non-anthracycline ODs in 11 dogs, and 3 cat ODs, were collected. Overdoses in dogs included carboplatin, cyclophosphamide, L-asparaginase, lomustine, mustargen, vincristine, and vinorelbine. The cat ODs included doxorubicin and vincristine. In dogs, the median OD was 2.1x (range: 1.2-10x) the intended dose. All dogs survived the OD and developed a variety of gastrointestinal and hematologic toxicities of varying grades. Both cats with a 2.4x vincristine OD died despite supportive care. The cat who received a 2x OD of doxorubicin survived the event, experiencing Veterinary Cooperative Oncology Group-common terminology criteria for adverse events (VCOG) grade I thrombocytopenia and anemia, and VCOG grade II neutropenia. Chemotherapy ODs appear to be rare in veterinary medicine and are typically 2-3xs the intended dose. Clinical effects include VCOG grade I and II gastrointestinal distress and VCOG grade III and IV hematologic effects. With appropriate supportive care, most patients will survive the event. Life-threatening events are more common in cats following vincristine ODs.
化疗过量是使用抗肿瘤药物后可能发生的严重并发症。然而，在兽医学中，关于化疗过量的情况却知之甚少。这项回顾性研究的目的是报告伴侣动物医学中已知化疗过量的发生率、类型和原因。我们向美国兽医内科学院肿瘤学和内科学邮件列表征集犬猫化疗过量病例。化疗过量被定义为给予的化疗剂量比预期高10%，或给药间隔比计划短。我们收集了11只犬的12例非蒽环类化疗过量病例和3例猫的化疗过量病例。犬的过量药物包括卡铂、环磷酰胺、L-天冬酰胺酶、洛莫司汀、氮芥、长春新碱和长春瑞滨。猫的化疗过量药物包括多柔比星和长春新碱。在犬中，化疗过量的中位数为预期剂量的2.1倍（范围：1.2 - 10倍）。所有犬在化疗过量后均存活，并出现了不同程度的各种胃肠道和血液学毒性。两只长春新碱过量2.4倍的猫尽管接受了支持治疗仍死亡。接受多柔比星过量2倍的猫在事件中存活下来，出现了兽医合作肿瘤学组不良事件通用术语标准（VCOG）I级血小板减少和贫血，以及VCOG II级中性粒细胞减少。化疗过量在兽医学中似乎很少见，通常是预期剂量的2 - 3倍。临床影响包括VCOG I级和II级胃肠道不适以及VCOG III级和IV级血液学影响。通过适当的支持治疗，大多数患者将在事件中存活。长春新碱过量后，危及生命的事件在猫中更为常见。
