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12 周联合化疗后洛莫司汀巩固治疗对犬 B 细胞和 T 细胞淋巴瘤的疗效和耐受性。

Efficacy and tolerability of a 12-week combination chemotherapy followed by lomustine consolidation treatment in canine B- and T-cell lymphoma.

机构信息

Small Animal Hospital, University of Veterinary Medicine Hannover, Bünteweg 9, Gebäude 280, 30559, Hannover, Germany.

Center for Small Animal Medicine, VetSpezial, Im Kornfeld 7, 31275, Lehrte, Germany.

出版信息

Acta Vet Scand. 2022 Dec 12;64(1):36. doi: 10.1186/s13028-022-00660-z.

Abstract

BACKGROUND

High-grade lymphoma in dogs is a chemotherapy-responsive neoplasia with remission rates exceeding 80% under combination chemotherapy protocols. Usually these protocols are intensive and 24 + weeks. The objective of the present study was to investigate if a shorter protocol combined with an oral lomustine maintenance treatment (3 × in 8 weeks) would present an acceptable result, both for B- and T-cell lymphomas, and for the different types of lymphomas normally encountered in private veterinary practice.

RESULTS

144 dogs entered the study. Lymphoma types included multicentric (n = 123), alimentary (n = 13), miscellaneous (n = 7), and mediastinal lymphoma (n = 1). Overall response rate was 83.3% (B-cell: 86.6%, T-cell: 79.4%). Complete remission (CR) was achieved in 72.2% (B-cell: 77.3%, T-cell: 67.6%) and partial remission (PR) in 11.1% (B-cell: 9.3%, T-cell: 11.8%) of the dogs. Median duration of first CR amounted to 242 days (B-cell: 263 d, T-cell: 161 d). Median survival in dogs with CR was 374 days (B-cell: 436 d, T-cell: 252 d), and median overall survival time was 291 days (B-cell: 357d, T-cell: 210d). Immunophenotype demonstrated an independent significant influence on duration of remission and survival in the whole group. Findings of splenic and hepatic cytology were not significant associated with patient outcome. Treatment was well tolerated; the majority of adverse events were classified as grade 1 or 2.

CONCLUSIONS

Short-term chemotherapy followed by lomustine consolidation leads to compara-ble remission and survival times compared to conventional protocols with cyclophosphamide, doxorubicin, vincristine and prednisolone with acceptable toxicosis in dogs with both B-cell and T-cell lymphoma.

摘要

背景

在犬科动物中,高级别淋巴瘤是一种对化疗有反应的肿瘤,在联合化疗方案下缓解率超过 80%。通常这些方案是密集的,持续 24 周以上。本研究的目的是研究是否可以采用较短的方案,并结合口服洛莫司汀维持治疗(每 8 周 3 次),对于 B 细胞和 T 细胞淋巴瘤,以及在私人兽医实践中常见的不同类型的淋巴瘤,都能获得可接受的结果。

结果

共有 144 只狗入组该研究。淋巴瘤类型包括多中心性(n=123)、胃肠道(n=13)、杂项(n=7)和纵隔淋巴瘤(n=1)。总体反应率为 83.3%(B 细胞:86.6%,T 细胞:79.4%)。完全缓解(CR)的比例为 72.2%(B 细胞:77.3%,T 细胞:67.6%),部分缓解(PR)的比例为 11.1%(B 细胞:9.3%,T 细胞:11.8%)。首次 CR 的中位持续时间为 242 天(B 细胞:263 天,T 细胞:161 天)。CR 犬的中位生存时间为 374 天(B 细胞:436 天,T 细胞:252 天),总生存时间的中位值为 291 天(B 细胞:357 天,T 细胞:210 天)。免疫表型在整个组中显示出对缓解和生存时间有独立的显著影响。脾脏和肝脏细胞学检查结果与患者预后无显著相关性。治疗耐受性良好,大多数不良事件被归类为 1 级或 2 级。

结论

与使用环磷酰胺、多柔比星、长春新碱和泼尼松龙的传统方案相比,短期化疗后进行洛莫司汀巩固治疗,可使 B 细胞和 T 细胞淋巴瘤犬的缓解时间和生存时间相当,且毒性可接受。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a9c/9743771/10ee001cacd7/13028_2022_660_Fig1_HTML.jpg

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