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自体骨髓移植作为犬淋巴瘤的巩固治疗:全身照射不同方案的疗效和毒性

Autologous marrow transplantation as consolidation therapy for canine lymphoma: efficacy and toxicity of various regimens of total body irradiation.

作者信息

Deeg H J, Appelbaum F R, Weiden P L, Hackman R C, Graham T C, Storb R C

出版信息

Am J Vet Res. 1985 Sep;46(9):2016-8.

PMID:3901841
Abstract

Dogs with malignant lymphoma were given chemotherapy consisting of nitrogen mustard, vincristine sulfate, prednisone, L-asparaginase, and 6-mercaptopurine (MOPA-6) for 14 days. Among 62 dogs that completed treatment with MOPA-6, 47 (76%) had complete remission, and 13 (21%) had partial remission and 2 had no response to chemotherapy. Twenty-two of the 62 dogs were not returned by their owners for additional therapy and died 15 to 391 (median 21) days after MOPA-6 from infections or recurrent disease. A median of 1 month after starting MOPA-6 therapy, 40 dogs (35 in complete remission, 5 in partial remission) were given total body irradiation (TBI), followed by infusion of fresh autologous marrow. Twenty dogs were given 13.5 Gray (Gy) of TBI at 4 centi-Gray (cGy)/min. Among 16 evaluable dogs, 7 had recurrence of lymphoma at a median of 169 days. Two dogs died with veno-occlusive disease of the liver, 3 with pneumonia, 3 with hemorrhage, and 1 was killed. Twenty dogs were given 11.8 to 14.7 Gy of TBI at 2 cGy/min. Among 14 evaluable dogs, 9 had recurrence of lymphoma at a median of 117 days. The remaining 5 dogs were killed at 110 to 680 days; lymphoma was not present at necropsy. The results indicated that doses of TBI of 11.8 to 14.7 Gy did not reduce the recurrence of lymphoma, compared with results obtained in a previous study with 8.4 Gy of TBI. Furthermore, increased doses of TBI increased acute and delayed toxicities. Alternatively, recurrent disease may have been due to lymphoma cells contained in the infused remission marrow.

摘要

患有恶性淋巴瘤的犬只接受了为期14天的化疗,化疗药物包括氮芥、硫酸长春新碱、泼尼松、L-天冬酰胺酶和6-巯基嘌呤(MOPA-6)。在62只完成MOPA-6治疗的犬只中,47只(76%)完全缓解,13只(21%)部分缓解,2只对化疗无反应。62只犬中有22只未被主人送回接受进一步治疗,在MOPA-6治疗后15至391天(中位数21天)因感染或疾病复发死亡。开始MOPA-6治疗后中位数1个月,40只犬(35只完全缓解,5只部分缓解)接受了全身照射(TBI),随后输注新鲜自体骨髓。20只犬以4厘戈瑞(cGy)/分钟的剂量接受13.5戈瑞(Gy)的TBI。在16只可评估的犬只中,7只在中位数169天时淋巴瘤复发。2只犬死于肝静脉闭塞性疾病,3只死于肺炎,3只死于出血,1只被安乐死。20只犬以2 cGy/分钟的剂量接受11.8至14.7 Gy的TBI。在14只可评估的犬只中,9只在中位数117天时淋巴瘤复发。其余5只犬在110至680天时被安乐死;尸检时未发现淋巴瘤。结果表明,与先前8.4 Gy TBI的研究结果相比,11.8至14.7 Gy的TBI剂量并未降低淋巴瘤的复发率。此外,增加TBI剂量会增加急性和迟发性毒性。另外,疾病复发可能是由于输注的缓解期骨髓中含有淋巴瘤细胞。

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