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应用人静脉注射免疫球蛋白治疗 12 例新诊断恶性疾病和疑似继发性免疫介导性血小板减少症的犬。

Use of human intravenous immunoglobulin for the treatment of 12 dogs with newly diagnosed malignant disease and presumed secondary immune-mediated thrombocytopenia.

机构信息

Internal Medicine Department, Metropolitan Animal Specialty Hospital, 6565 Santa Monica Boulevard, Los Angeles, CA, 90038, USA.

出版信息

J Small Anim Pract. 2024 May;65(5):338-345. doi: 10.1111/jsap.13700. Epub 2024 Jan 19.

Abstract

OBJECTIVES

To evaluate the safety and efficacy of human intravenous immunoglobulin in dogs with newly diagnosed malignancy and presumed secondary immune-mediated thrombocytopenia.

MATERIALS AND METHODS

Twelve client-owned dogs with newly diagnosed malignant disease and presumed secondary immune-mediated thrombocytopenia were prospectively enrolled to receive a single infusion of human intravenous immunoglobulin at a dose of 0.5 to 1 mg/kg intravenous over 8 hours. A complete treatment response was defined as a platelet estimation of ≥40,000 platelets/μL within 24 hours and a partial response within 48 hours from the completion of human intravenous immunoglobulin infusion. No treatment response was defined as a platelet estimation remaining <40,000 platelets/μL over 48 hours from the completion of the human intravenous immunoglobulin infusion. This pilot study had a prospective, open-label, uncontrolled design.

RESULTS

Out of the 12 enrolled dogs, seven completed the study. A complete treatment response to human intravenous immunoglobulin was identified in one lymphoma dog and a partial response was noted in another lymphoma dog. The remaining 10 dogs had no response to human intravenous immunoglobulin. No clinically relevant adverse reactions to human intravenous immunoglobulin occurred in any of the 12 initially enrolled dogs during the infusion and over a 3-month follow-up period for the seven surviving dogs.

CLINICAL SIGNIFICANCE

The results of this study suggest that the use of human intravenous immunoglobulin in dogs with newly diagnosed malignant disease and presumed secondary immune-mediated thrombocytopenia appears safe, but not effective for the treatment of thrombocytopenia. Larger multi-centre, prospective, double-blinded, placebo-controlled, outcome-based, malignancy-specific studies are needed to further evaluate these preliminary findings.

摘要

目的

评估人静脉注射免疫球蛋白在新诊断为恶性肿瘤且疑似继发免疫介导性血小板减少症的犬中的安全性和疗效。

材料和方法

12 只新诊断为恶性疾病且疑似继发免疫介导性血小板减少症的患犬被前瞻性纳入研究,以 0.5 至 1mg/kg 的剂量静脉输注 8 小时,接受单次人静脉免疫球蛋白输注。完全治疗反应定义为在人静脉免疫球蛋白输注完成后 24 小时内血小板计数≥40,000/μL,部分反应在 48 小时内完成。无治疗反应定义为在人静脉免疫球蛋白输注完成后 48 小时内血小板计数仍<40,000/μL。这项初步研究采用前瞻性、开放标签、非对照设计。

结果

12 只入组犬中,7 只完成了研究。1 只淋巴瘤犬出现完全治疗反应,另 1 只淋巴瘤犬出现部分反应。其余 10 只犬对人静脉免疫球蛋白无反应。在 12 只最初入组的犬中,没有 1 只在输注期间和 7 只存活犬的 3 个月随访期间出现与使用人静脉免疫球蛋白相关的临床相关不良反应。

临床意义

本研究结果表明,在新诊断为恶性肿瘤且疑似继发免疫介导性血小板减少症的犬中使用人静脉免疫球蛋白似乎是安全的,但对血小板减少症的治疗无效。需要更大规模的多中心、前瞻性、双盲、安慰剂对照、基于结果的、针对特定恶性肿瘤的研究,以进一步评估这些初步发现。

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