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血液学和血液生化参数作为采用COP和L-COP方案治疗的犬多中心淋巴瘤生存预后指标

Hematological and blood biochemistry parameters as prognostic indicators of survival in canine multicentric lymphoma treated with COP and L-COP protocols.

作者信息

Sutthigran Somchin, Saisawart Phasamon, Teewasutrakul Patharakrit, Sirivisoot Sirintra, Thanaboonnipat Chutimon, Rungsipipat Anudep, Choisunirachon Nan

机构信息

Department of Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand.

Small Animal Teaching Hospital, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Rd., Pathumwan, Bangkok 10330, Thailand.

出版信息

Vet World. 2024 Feb;17(2):344-355. doi: 10.14202/vetworld.2024.344-355. Epub 2024 Feb 8.

Abstract

BACKGROUND AND AIM

Hematological and blood chemistry parameters are crucial for evaluating and monitoring canine multicentric lymphoma during chemotherapy. Pre-treatment hematological and blood chemistry parameters can be used as prognostic survival outcomes for this disease. Therefore, this study aimed to investigate the effect of hematological and blood chemistry parameters pre-treatment and 4 weeks post-treatment on the survival outcomes of dogs treated with either a combination of cyclophosphamide, vincristine, and prednisolone (COP) or a combination of COP with L-asparaginase (L-COP) protocols.

MATERIALS AND METHODS

We conducted a retrospective study. Medical records and hematological and blood chemistry parameters of 41 dogs with multicentric lymphoma treated with L-COP (n = 26) and the COP protocols (n = 15) were obtained from the hospital information system. Most cases were classified as high-grade lymphoma based on the Kiel cytological classification. The effects of hematological and blood chemistry parameters on survival outcomes were investigated using the Cox proportional hazard regression model. The median survival time (MST) for each hematological and blood chemistry parameter affecting survival outcome was established and compared using the Kaplan-Meier product limit method with the log-rank test.

RESULTS

Dogs with high-grade multicentric lymphoma that were treated with the COP protocol and had monocytosis at pre-treatment had a significantly shorter MST than dogs with normal monocyte counts (p = 0.033). In addition, dogs with azotemia, both pre-treatment and 4 weeks post-treatment, had a significantly shorter MST than dogs with normal serum creatinine levels (p = 0.012). Dogs with high-grade multicentric lymphoma treated with the L-COP protocol who had hypoalbuminemia (serum albumin concentration <2.5 mg/dL) at both pre-treatment and 4 weeks post-treatment had a significantly shorter MST than dogs with normal serum albumin levels (p < 0.001). Furthermore, dogs with leukocytosis at 4 weeks post-treatment had a significantly shorter MST than those with a normal total white blood cell count (p = 0.024).

CONCLUSION

Serum albumin level can serve as a simple negative prognostic indicator of survival outcomes in dogs with high-grade multicentric lymphoma treated with the L-COP protocol. Dogs with hypoalbuminemia pre-treatment and 4 weeks post-treatment tended to have a shorter MST than those with normal serum albumin concentrations.

摘要

背景与目的

血液学和血液生化参数对于评估和监测犬多中心淋巴瘤化疗期间的情况至关重要。治疗前的血液学和血液生化参数可作为该疾病生存预后的指标。因此,本研究旨在探讨治疗前及治疗后4周的血液学和血液生化参数对接受环磷酰胺、长春新碱和泼尼松龙联合方案(COP)或COP与L-天冬酰胺酶联合方案(L-COP)治疗的犬生存结局的影响。

材料与方法

我们进行了一项回顾性研究。从医院信息系统获取了41只接受L-COP方案(n = 26)和COP方案(n = 15)治疗的多中心淋巴瘤犬的病历以及血液学和血液生化参数。根据基尔细胞学分类,大多数病例被归类为高级别淋巴瘤。使用Cox比例风险回归模型研究血液学和血液生化参数对生存结局的影响。使用Kaplan-Meier乘积限界法和对数秩检验确定并比较影响生存结局的每个血液学和血液生化参数的中位生存时间(MST)。

结果

接受COP方案治疗且治疗前单核细胞增多的高级别多中心淋巴瘤犬的MST明显短于单核细胞计数正常的犬(p = 0.033)。此外,治疗前及治疗后4周均患有氮质血症的犬的MST明显短于血清肌酐水平正常的犬(p = 0.012)。接受L-COP方案治疗的高级别多中心淋巴瘤犬,治疗前及治疗后4周均患有低白蛋白血症(血清白蛋白浓度<2.5 mg/dL)的犬的MST明显短于血清白蛋白水平正常的犬(p < 0.001)。此外,治疗后4周白细胞增多的犬的MST明显短于总白细胞计数正常的犬(p = 0.024)。

结论

血清白蛋白水平可作为接受L-COP方案治疗的高级别多中心淋巴瘤犬生存结局的一个简单的负面预后指标。治疗前及治疗后4周患有低白蛋白血症的犬的MST往往短于血清白蛋白浓度正常的犬。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da12/11000476/5d0cee232218/Vetworld-17-344-g001.jpg

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