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.
J Vet Intern Med. 2024 May-Jun;38(3):1693-1705. doi: 10.1111/jvim.17051. Epub 2024 Mar 22.
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.
Fifty cats with a diagnosis of MRD.
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.
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.
Our study confirmed the guarded prognosis of MRD in cats and identified risk factors for shorter survival times.
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。
50 只诊断为 MRD 的猫。
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。
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。
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。