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描述性分析和骨髓瘤相关疾病猫的预后因素:50 例多中心回顾性研究。

Descriptive analysis and prognostic factors in cats with myeloma-related disorders: A multicenter retrospective study of 50 cases.

机构信息

Ecole Nationale Vétérinaire d'Alfort-CHUVA, Service de Médecine Interne, Maisons-Alfort, France.

Université de Lyon, VetAgro Sup, Service de médecine interne, Marcy l'Etoile, France.

出版信息

J Vet Intern Med. 2024 May-Jun;38(3):1693-1705. doi: 10.1111/jvim.17051. Epub 2024 Mar 22.

Abstract

BACKGROUND

Myeloma-related disorders (MRDs) are rare and poorly documented neoplasms of cats.

HYPOTHESIS/OBJECTIVES: To describe clinical, clinicopathologic, and imaging findings, response to treatment, and survival time and to identify factors associated with shorter outcomes in cats with MRD.

ANIMALS

Fifty cats with a diagnosis of MRD.

METHODS

Cats with paraproteinemia confirmed by serum protein electrophoresis (SPE) and either intramedullary plasmacytosis >10%, marked cytonuclear atypia with intramedullary plasmacytosis that ranged between 5% and 10%, or cytologically or histologically confirmed visceral infiltration were retrospectively included from several veterinary referral centers.

RESULTS

Bone marrow plasmacytosis and splenic or hepatic involvement were present in 17/27 cats (63%), 36/42 cats (86%), and 27/38 cats (71%), respectively. Anemia was reported in 33/49 cats (67%) and thrombocytopenia in 16/47 cats (34%). Some of the treatments that the cats received included melphalan and prednisolone (n = 19), cyclophosphamide and prednisolone (n = 10), chlorambucil and prednisolone (n = 4), prednisolone (n = 4), or other (n = 4). The overall response rates to melphalan, cyclophosphamide, and chlorambucil in combination with prednisolone were 87%, 90%, and 100%, respectively. Adverse events to melphalan or cyclophosphamide occurred in 65% and 23% of cats, respectively. Median survival time was 122 days (range, 0-1403) and was not significantly associated with chemotherapy protocol. Anemia (hazard ratio [HR], 3.1; 95% confidence interval [CI], 1.0-9.8) and thrombocytopenia (HR, 2.7; 95% CI, 1.2-6.0) were risk factors for shorter survival.

CONCLUSIONS AND CLINICAL IMPORTANCE

Our study confirmed the guarded prognosis of MRD in cats and identified risk factors for shorter survival times.

摘要

背景

骨髓瘤相关疾病(MRD)是猫中罕见且记录不佳的肿瘤。

假设/目的:描述临床、临床病理和影像学表现、对治疗的反应以及生存时间,并确定与 MRD 猫预后较差相关的因素。

动物

50 只诊断为 MRD 的猫。

方法

从几家兽医转诊中心回顾性纳入通过血清蛋白电泳(SPE)证实存在单克隆丙种球蛋白血症,骨髓浆细胞增多>10%,伴有明显的核浆异型性,骨髓浆细胞增多介于 5%至 10%之间,或细胞学或组织学证实内脏浸润的猫。

结果

骨髓浆细胞增多和脾脏或肝脏受累分别见于 27/38 只(63%)、36/42 只(86%)和 17/27 只(63%)猫。33/49 只(67%)猫存在贫血,16/47 只(34%)猫存在血小板减少症。猫接受的一些治疗包括美法仑和泼尼松龙(n = 19)、环磷酰胺和泼尼松龙(n = 10)、苯丁酸氮芥和泼尼松龙(n = 4)、泼尼松龙(n = 4)或其他(n = 4)。美法仑、环磷酰胺和苯丁酸氮芥联合泼尼松龙的总缓解率分别为 87%、90%和 100%。美法仑或环磷酰胺的不良反应分别发生在 65%和 23%的猫中。中位生存时间为 122 天(范围 0-1403),与化疗方案无显著相关性。贫血(危险比[HR],3.1;95%置信区间[CI],1.0-9.8)和血小板减少症(HR,2.7;95% CI,1.2-6.0)是生存时间较短的危险因素。

结论和临床意义

本研究证实了猫的 MRD 预后不佳,并确定了生存时间较短的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a526/11099758/15bc3090e9bf/JVIM-38-1693-g003.jpg

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