RESUMEN
Canine transmissible venereal tumor (TVTC) is a highly casuistic transmissible neoplasm in Brazil. Chemotherapy with vincristine sulfate is considered the treatment of choice, but the need for weekly applications and hematological monitoring, in addition to costs, are obstacles to owners' adhesion to the treatment. Lomustine is an alkylating class antineoplastic agent, and because it is administered orally, it is a more practical and less costly treatment option for the owners of animals with neoplasms sensitive to the drug. This study evaluated the therapeutic efficacy of lomustine in dogs affected by TVTC. Twelve dogs with cytopathological diagnosis of natural genital TVTC were selected. The dogs were submitted to the experimental protocol with lomustine administration at doses of 70 to 85 mg/m2 orally every 21 days, totaling a maximum of two administration cycles. The animals were reevaluated every 7 days until a maximum of +49 days after the first dose of lomustine, to monitor the regression of neoplastic lesions through measurements. Among the 12 dogs submitted to the lomustine protocol, 8/12 achieved complete remission of the neoplasm and were considered cured (66.6%), 1/12 had partial response to treatment (8.33%) and 3/12 had stable disease (25%). Important adverse effects such as severe neutrophilic leukopenia were detected in 3/12 dogs (25%). The clinical study indicated that lomustine may be a treatment option for TVTC.
O tumor venéreo transmissível canino (TVTC) é uma neoplasia transmissível de elevada casuística no Brasil. A quimioterapia com sulfato de vincristina é considerada o tratamento de escolha, mas a necessidade de aplicações semanais e acompanhamento hematológico, além dos custos, são obstáculos à adesão dos proprietários ao tratamento. A lomustina é um antineoplásico da classe dos agentes alquilantes e, por ser administrado por via oral, representa um opção de tratamento mais prática e menos onerosa para os proprietários de animais com neoplasias. O objetivo deste estudo foi avaliar a eficácia terapêutica da lomustina em cães acometidos por TVTC. Foram selecionados 12 cães com diagnóstico citopatológico de TVTC genital de ocorrência natural. Os cães foram submetidos ao protocolo experimental com administração de lomustina nas doses de 70 a 85 mg/m2 por via oral a cada 21 dias, totalizando no máximo dois ciclos de administração. Os animais foram reavaliados a cada sete dias até um máximo de +49 dias após a primeira dose de lomustina, para monitorar a regressão das lesões neoplásicas por meio de mensuração das lesões. Entre os 12 cães submetidos ao protocolo, 8/12 obtiveram remissão completa da neoplasia e foram considerados curados (66,6%), 1/12 tiveram resposta parcial ao tratamento (8,33%) e 3/12 tiveram doença estável (25%). Efeitos adversos importantes, como leucopenia neutrofílica grave, foram detectados em 3/12 cães (25%). O estudo clínico indicou que a lomustina pode ser uma opção de tratamento para TVTC.
Asunto(s)
Animales , Perros , Tumores Venéreos Veterinarios/terapia , Enfermedades de los Perros , Lomustina/uso terapéutico , Neoplasias/veterinariaRESUMEN
Background: Transmissible venereal tumor (TVT) is a highly contagious round cell neoplasm that affects dogs, and itis usually transmitted through coitus. The tumor is mainly located in the genital area; however, the neoplasm can also beextragenital, affecting the nose, mouth, and eyes, as well as the skin and superficial lymph nodes. Cytological examinationis the most commonly used method for definitive diagnosis due to its low cost and fast execution. Chemotherapy, radiotherapy, surgical resection, and other procedures such as cryosurgery are the possible treatment options. The objective ofthis report was to describe a case of extragenital TVT with nasal primary site and metastasis in the bone tissue in a dogtreated at a private veterinary hospital in the city of Belém, Pará, Brazil.Case: A 6-year-old male domiciliary Labrador Retriever dog, weighing 24.2 kg, received oncologic treatment in a privateveterinary hospital in the city of Belém, Pará, Brazil. The animal had a history of neoplastic disease, and he had undergoneTVT resection associated with chemotherapy treatment more than 3 years ago. The clinical examination revealed a volumeincrease in the periorbital region, left lateral ocular displacement, left nostril excessive epistaxis, recurrent sneezing, cough,and pain signs, and tumor metastasis was suspected. Complementary exams of oncological cytology, computed tomography(CT), hemogram, and serum biochemistry were requested for diagnosis and staging of the condition, and supportive therapywas prescribed. The cytological report showed a dense population of neoplastic round cells with characteristics of TVT. CTindicated the presence of a heterogeneous hypodense mass with irregular contours and partially defined limits, with slightuptake of the intravenously injected contrast medium that obliterated the nasal cavity, maxillary recess, nasopharyngealmeatus, frontal sinus, and sphenoid sinus on the left side...
Asunto(s)
Animales , Perros , Lomustina/uso terapéutico , Neoplasias Nasales/veterinaria , Neoplasias Óseas/secundario , Neoplasias Óseas/veterinaria , Tumores Venéreos Veterinarios/complicaciones , Tumores Venéreos Veterinarios/diagnóstico por imagen , Administración Metronómica/veterinaria , Tomografía Computarizada por Rayos X/veterinariaRESUMEN
Background: Transmissible venereal tumor (TVT) is a highly contagious round cell neoplasm that affects dogs, and itis usually transmitted through coitus. The tumor is mainly located in the genital area; however, the neoplasm can also beextragenital, affecting the nose, mouth, and eyes, as well as the skin and superficial lymph nodes. Cytological examinationis the most commonly used method for definitive diagnosis due to its low cost and fast execution. Chemotherapy, radiotherapy, surgical resection, and other procedures such as cryosurgery are the possible treatment options. The objective ofthis report was to describe a case of extragenital TVT with nasal primary site and metastasis in the bone tissue in a dogtreated at a private veterinary hospital in the city of Belém, Pará, Brazil.Case: A 6-year-old male domiciliary Labrador Retriever dog, weighing 24.2 kg, received oncologic treatment in a privateveterinary hospital in the city of Belém, Pará, Brazil. The animal had a history of neoplastic disease, and he had undergoneTVT resection associated with chemotherapy treatment more than 3 years ago. The clinical examination revealed a volumeincrease in the periorbital region, left lateral ocular displacement, left nostril excessive epistaxis, recurrent sneezing, cough,and pain signs, and tumor metastasis was suspected. Complementary exams of oncological cytology, computed tomography(CT), hemogram, and serum biochemistry were requested for diagnosis and staging of the condition, and supportive therapywas prescribed. The cytological report showed a dense population of neoplastic round cells with characteristics of TVT. CTindicated the presence of a heterogeneous hypodense mass with irregular contours and partially defined limits, with slightuptake of the intravenously injected contrast medium that obliterated the nasal cavity, maxillary recess, nasopharyngealmeatus, frontal sinus, and sphenoid sinus on the left side...(AU)
Asunto(s)
Animales , Perros , Tumores Venéreos Veterinarios/complicaciones , Tumores Venéreos Veterinarios/diagnóstico por imagen , Neoplasias Óseas/secundario , Neoplasias Óseas/veterinaria , Neoplasias Nasales/veterinaria , Lomustina/uso terapéutico , Tomografía Computarizada por Rayos X/veterinaria , Administración Metronómica/veterinariaAsunto(s)
Trasplante de Células Madre Hematopoyéticas , Linfoma , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ciclofosfamida/uso terapéutico , Etopósido/uso terapéutico , Humanos , Lomustina/uso terapéutico , Linfoma/tratamiento farmacológico , Recurrencia Local de Neoplasia , Acondicionamiento Pretrasplante , Trasplante AutólogoRESUMEN
Background: Bone marrow primary malignancies are denominated leukemias, classified as myeloid or lymphoid, according to the cell lineage, and acute or chronic, according to the cell´s state of maturation. In cats, acute lymphoid leukemiais the most common form, especially in regions endemic for feline leukemia virus and / or feline immunodeficiency virus.A new treatment protocol for lymphomas, called LOPH, was described for animals with FeLV persistent viremia. Thisstudy aimed to report a case of a cat presenting with FeLV associated acute leukemia and treated with the LOPH protocol,and, in the rescue phase, a modification of the D-MAC protocol, denominated D-MHC.Case: A 4-year-old mixed breed intact queen was attended due to lethargy and inappetence. The patient did not present anyrelevant abnormalities in the clinical exam and complementary exams were performed including complete blood count,biochemical profile, SNAP Feline Triple Test, chest radiographs and abdominal ultrasound. Imaging tests and biochemicalvalues were unremarkable, but the patient presented a reagent result for FeLV and severe leukocytosis due to lymphocytosis. The morphological evaluation of the blood smear revealed the presence of blasts, in a concentration greater than 20%of the nucleated cells, which allowed the characterization of a leukemic state, probably lymphoid. First-line treatmentwas based on the LOPH protocol, including Lomustine, Vincristine, Prednisolone and Doxorubicin, in four-week cycles.Nevertheless, during the third cycle, 66 days after the institution of this protocol, the patient presented a febrile conditionalong with marked leukocytosis due to lymphocytosis, confirming leukemia recurrence. A rescue attempt was performedwith a modification of the D-MAC protocol, originally consisting of the combination of dexamethasone, melphalan, actinomycin-D and cytarabine, but with replacement of actinomycin-D by doxorubicin, and therefore denominated D-MHC....(AU)
Asunto(s)
Animales , Gatos , Virus de la Leucemia Felina , Leucemia Felina , Quimioterapia Combinada/veterinaria , Gatos/sangre , Linfocitosis/veterinaria , Doxorrubicina/uso terapéutico , Lomustina/uso terapéutico , Citarabina/uso terapéuticoRESUMEN
Background: Bone marrow primary malignancies are denominated leukemias, classified as myeloid or lymphoid, according to the cell lineage, and acute or chronic, according to the cell´s state of maturation. In cats, acute lymphoid leukemiais the most common form, especially in regions endemic for feline leukemia virus and / or feline immunodeficiency virus.A new treatment protocol for lymphomas, called LOPH, was described for animals with FeLV persistent viremia. Thisstudy aimed to report a case of a cat presenting with FeLV associated acute leukemia and treated with the LOPH protocol,and, in the rescue phase, a modification of the D-MAC protocol, denominated D-MHC.Case: A 4-year-old mixed breed intact queen was attended due to lethargy and inappetence. The patient did not present anyrelevant abnormalities in the clinical exam and complementary exams were performed including complete blood count,biochemical profile, SNAP Feline Triple Test, chest radiographs and abdominal ultrasound. Imaging tests and biochemicalvalues were unremarkable, but the patient presented a reagent result for FeLV and severe leukocytosis due to lymphocytosis. The morphological evaluation of the blood smear revealed the presence of blasts, in a concentration greater than 20%of the nucleated cells, which allowed the characterization of a leukemic state, probably lymphoid. First-line treatmentwas based on the LOPH protocol, including Lomustine, Vincristine, Prednisolone and Doxorubicin, in four-week cycles.Nevertheless, during the third cycle, 66 days after the institution of this protocol, the patient presented a febrile conditionalong with marked leukocytosis due to lymphocytosis, confirming leukemia recurrence. A rescue attempt was performedwith a modification of the D-MAC protocol, originally consisting of the combination of dexamethasone, melphalan, actinomycin-D and cytarabine, but with replacement of actinomycin-D by doxorubicin, and therefore denominated D-MHC....
Asunto(s)
Animales , Gatos , Leucemia Felina , Quimioterapia Combinada/veterinaria , Virus de la Leucemia Felina , Citarabina/uso terapéutico , Doxorrubicina/uso terapéutico , Gatos/sangre , Linfocitosis/veterinaria , Lomustina/uso terapéuticoRESUMEN
INTRODUCTION: Radiotherapy with procarbazine, lomustine, and vincristine (PCV) improves overall survival in patients with anaplastic oligodendroglioma 1p19q codeleted. PATIENTS AND METHODS: This retrospective analysis investigated outcomes in patients with anaplastic oligodendroglioma 1p19q codeleted compared two different protocols (radiotherapy plus temozolomide or PCV). The primary end points were overall survival and progression-free survival. Secondary endpoint was the radiological response. RESULTS: A total of 48 patients were included. Mean age was 43 years (range: 19-66 years), 26 were male (54.1%). Twenty-one patients received PCV and 27 temozolomide. The baseline characteristics were not difference between the groups. The progression-free survival and overall survival in the PCV group were 7.2 and 10.6 years respectively and temozolomide were 6.1 and 9.2 years, both statistically significant. The radiological response was present in 80.9% in PCV arm and 70.2% in temozolomide arm there was not statistical differences. The multivariate Cox model showed only the significant parameters the use of PCV protocol. The toxicity grade 3 or 4 was present in 42.8% in PCV arm and 11.1% in temozolomide arm. CONCLUSIONS: The most common strategy in the Latin America community is the substitution of the PCV for temozolomide. This retrospective study showed superior efficacy of PCV than temozolomide. The Latin American community effort must be made to be able to have the drugs to available for using as a first line of treatment.
TITLE: Radioterapia mas temozolomida o PCV en pacientes con oligodendroglioma anaplasico con codelecion 1p19q.Introduccion. La radioterapia con procarbacina, lomustina y vincristina (PCV) mejora la supervivencia global en pacientes con oligodendroglioma anaplasico con codelecion 1p19q, pero no esta disponible en America Latina. Pacientes y metodos. Analisis retrospectivo comparando dos protocolos diferentes, radioterapia mas temozolomida o PCV, en pacientes con oligodendroglioma anaplasico con codelecion 1p19q. Los objetivos primarios fueron la supervivencia global y la supervivencia libre de progresion, y el objetivo secundario, la respuesta radiologica. Resultados. Se incluyo a 48 pacientes, 26 de ellos varones (54,1%), con una edad media de 43 años (rango: 19-66 años). Veintiun pacientes recibieron PCV, y 27, temozolomida. Las caracteristicas iniciales no tuvieron diferencias entre los grupos. La supervivencia libre de progresion y la supervivencia global en el grupo con PCV fueron de 7,2 y 10,6 años, y en el grupo de temozolomida, de 6,1 y 9,2 años, respectivamente, unos resultados estadisticamente significativos. Hubo respuesta radiologica en el 80,9% en el brazo de PCV y el 70,2% en el brazo de temozolomida. El analisis multivariado de Cox mostro como unico parametro significativo el uso del protocolo PCV. El grado de toxicidad 3-4 estuvo presente en el 42,8% en el brazo de PCV y en el 11,1% en el brazo de temozolomida. Conclusiones. La estrategia mas comun en America Latina es la sustitucion de PCV por temozolomida. Este estudio retrospectivo mostro una eficacia superior de PCV que de la temozolomida. La diferencia obliga a la comunidad latinoamericana a hacer un esfuerzo colectivo para poder tener acceso a los medicamentos para su uso como primera linea de tratamiento.
Asunto(s)
Antineoplásicos Alquilantes/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/radioterapia , Oligodendroglioma/tratamiento farmacológico , Oligodendroglioma/radioterapia , Temozolomida/uso terapéutico , Adulto , Anciano , Neoplasias Encefálicas/genética , Terapia Combinada , Femenino , Eliminación de Gen , Humanos , Lomustina/uso terapéutico , Masculino , Persona de Mediana Edad , Oligodendroglioma/genética , Procarbazina/uso terapéutico , Estudios Retrospectivos , Vincristina/uso terapéutico , Adulto JovenRESUMEN
BACKGROUND: Cutaneous plasmacytosis (CP) is a syndrome of multiple cutaneous plasma cell tumors, in the absence of multiple myeloma. Although rare in both humans and dogs, treatment recommendations are usually extrapolated from multiple myeloma protocols. To date, no case series of CP have been described in the veterinary literature. HYPOTHESIS/OBJECTIVES: To describe clinical presentation, determine treatment response rates and duration, and report overall survival of dogs with CP. ANIMALS: Twenty-one client-owned dogs with CP. METHODS: Medical records of 21 dogs with CP were reviewed. Diagnosis was based on histopathologic evaluation of at least 1 representative cutaneous or subcutaneous lesion in dogs with ≥3 lesions. Dogs with suspicion of multiple myeloma were excluded. RESULTS: The most commonly affected breeds were the golden (5/21) and Labrador retriever (3/21). Fourteen of 21 dogs had >10 lesions, with some having >100. Lesions commonly were described as round, raised, pink-to-red, and variably alopecic or ulcerated. The most commonly used drug protocol was combined melphalan and prednisone, with an overall response rate (ORR) of 73.7% (14/19 dogs). Single-agent lomustine was associated with a similar ORR of 71.4% (5/7 dogs). For all treatments combined, the median progression-free interval after the first treatment was 153 days. The median survival time from the first treatment was 542 days. CONCLUSIONS AND CLINICAL IMPORTANCE: Alkylating agents were effective in inducing remission of CP; corticosteroids, melphalan, and lomustine were the most commonly used drugs. Survival times were similar to those reported in dogs with multiple myeloma treated with alkylating agents.
Asunto(s)
Enfermedades de los Perros/patología , Plasmacitoma/veterinaria , Neoplasias Cutáneas/veterinaria , Animales , Antineoplásicos Alquilantes/administración & dosificación , Antineoplásicos Alquilantes/uso terapéutico , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/tratamiento farmacológico , Enfermedades de los Perros/mortalidad , Perros , Quimioterapia Combinada/veterinaria , Femenino , Lomustina/uso terapéutico , Masculino , Melfalán/administración & dosificación , Melfalán/uso terapéutico , Plasmacitoma/diagnóstico , Plasmacitoma/tratamiento farmacológico , Plasmacitoma/patología , Prednisona/administración & dosificación , Prednisona/uso terapéutico , Piel/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/patologíaRESUMEN
Metronomic chemotherapy consists of an anticancer modality treatment. It is applicable in patients at an advanced stage, with the objective of increasing overall survival. The aim of this study was to report an anal sac apocrine carcinoma case in a dog with lymph node metastasis treated with metronomic chemotherapy sequential to surgery and conventional chemotherapy using gemcitabine and carboplatin. Metronomic chemotherapy was associated with cyclooxygenase-2 (COX-2) inhibitors, due to strong tumor COX-2 immunohistochemistry expression. Metronomic chemotherapy was initiated with cyclophosphamide, but it was replaced by lomustine, also in metronomic dosage, due to adverse effects. Treatment showed effectiveness, since the patient's overall survival exceeded 1095 days (36 months), considerably higher than the mean overall survival expected for this pathology.(AU)
Quimioterapia metronômica consiste em uma modalidade de tratamento anticancerígeno, aplicável a pacientes em estadiamento avançado, com o objetivo de aumentar a sobrevida global. O objetivo deste trabalho foi relatar um caso de carcinoma apócrino do saco anal, em uma cadela, com metástase em linfonodo tratado com quimioterapia metronômica sequencial à cirurgia e quimioterapia convencional utilizando-se gencitabina e carboplatina. O tratamento metronômico foi associado ao uso de inibidores de ciclo-oxigenase-2 (COX-2), baseando-se na constatação de sua expressão tumoral. A terapia metronômica iniciou-se com ciclofosfamida, mas houve necessidade de substituição pela lomustina, também em dose metronômica, devido à ocorrência de efeitos adversos. O tratamento mostrou ser eficaz, pois a sobrevida do paciente ultrapassa 1095 dias (36 meses) desde a cirurgia, sendo consideravelmente maior que a média relatada para essa patologia.(AU)
Asunto(s)
Animales , Femenino , Perros , Inhibidores de la Angiogénesis , Glándulas Apocrinas/ultraestructura , Carcinoma/tratamiento farmacológico , Carcinoma/veterinaria , Ciclofosfamida/uso terapéutico , Lomustina/uso terapéutico , Metástasis LinfáticaRESUMEN
Metronomic chemotherapy consists of an anticancer modality treatment. It is applicable in patients at an advanced stage, with the objective of increasing overall survival. The aim of this study was to report an anal sac apocrine carcinoma case in a dog with lymph node metastasis treated with metronomic chemotherapy sequential to surgery and conventional chemotherapy using gemcitabine and carboplatin. Metronomic chemotherapy was associated with cyclooxygenase-2 (COX-2) inhibitors, due to strong tumor COX-2 immunohistochemistry expression. Metronomic chemotherapy was initiated with cyclophosphamide, but it was replaced by lomustine, also in metronomic dosage, due to adverse effects. Treatment showed effectiveness, since the patient's overall survival exceeded 1095 days (36 months), considerably higher than the mean overall survival expected for this pathology.(AU)
Quimioterapia metronômica consiste em uma modalidade de tratamento anticancerígeno, aplicável a pacientes em estadiamento avançado, com o objetivo de aumentar a sobrevida global. O objetivo deste trabalho foi relatar um caso de carcinoma apócrino do saco anal, em uma cadela, com metástase em linfonodo tratado com quimioterapia metronômica sequencial à cirurgia e quimioterapia convencional utilizando-se gencitabina e carboplatina. O tratamento metronômico foi associado ao uso de inibidores de ciclo-oxigenase-2 (COX-2), baseando-se na constatação de sua expressão tumoral. A terapia metronômica iniciou-se com ciclofosfamida, mas houve necessidade de substituição pela lomustina, também em dose metronômica, devido à ocorrência de efeitos adversos. O tratamento mostrou ser eficaz, pois a sobrevida do paciente ultrapassa 1095 dias (36 meses) desde a cirurgia, sendo consideravelmente maior que a média relatada para essa patologia.(AU)
Asunto(s)
Animales , Femenino , Perros , Perros , Inhibidores de la Angiogénesis , Ciclofosfamida/uso terapéutico , Lomustina/uso terapéutico , Glándulas Apocrinas/ultraestructura , Carcinoma/tratamiento farmacológico , Carcinoma/veterinaria , Metástasis LinfáticaRESUMEN
The aim of this prospective study was to evaluate the clinical response of dogs with cutaneous lymphoma treated with lomustine (CCNU) and to identify possible adverse effects and toxicity during treatment. Fifteen dogs, seven females and eight males aged between five and 17 years old, diagnosed with cutaneous lymphoma by histopathological analysis were selected and treated with lomustine at 90 mg/m² every three weeks. Monitoring was carried out and consisted of the assessment of laboratory hematology and serum chemistry before and during treatment. Partial response was observed in 53.3% of the animals. None of the animals achieved a complete response and seven dogs (46.6%) had progressive disease. The median survival time was 22 days. The major hematological and biochemical changes found after therapy were leukopenia (73.3%), thrombocytopenia (60%) and anemia (46.1%). Renal and liver toxicity was observed in 40% and 73.3% of dogs, respectively. Hematocrit, total protein, leukocyte count, neutrophil count, serum creatinine, ALT, GGT, alkaline phosphatase and urine specific gravity were affected during therapy. The use of lomustine as a monotherapy in the treatment of canine cutaneous lymphoma was effective; however, adverse effects occurred and compromised the quality of life of the majority of dogs in this study. Therefore, lower doses of lomustine should be considered in future studies(AU)
O objetivo deste estudo prospectivo foi avaliar a resposta clínica de cães com linfoma cutâneo tratados com lomustina (CCNU) e identificar possíveis efeitos adversos e toxicidade durante o tratamento. Quinze cães, sendo 7 fêmeas e 8 machos, com idades entre 5 e 17 anos diagnosticados com linfoma cutâneo por avaliação histopatológica foram selecionados e tratados com lomustina na dose de 90 mg/m2 a cada três semanas. Os cães foram monitorados por avaliação hematológica e bioquímica sérica antes e durante o tratamento. A resposta parcial foi observada em 53,3% dos animais. Nenhum dos animais apresentou resposta completa e sete animais (46,6%) apresentaram progressão da doença. O tempo médio de sobrevida foi de 22 dias. As principais alterações hematológicas e bioquímicas observadas após o tratamento foram leucopenia (73,3%), trombocitopenia (60%) e anemia (46,1%). Sinais de toxicidade renal e hepática foram observados em 40% e 73,3% dos cães, respectivamente. Durante o tratamento foram afetados os parâmetros hematócrito, proteínas séricas totais, contagem de leucócitos, contagem de neutrófilos, creatinina sérica, ALT, GGT, fosfatase alcalina e densidade urinária. O uso de lomustina como monoterapia no tratamento do linfoma cutâneo canino foi efetivo; entretanto, efeitos adversos ocorreram e comprometeram a qualidade de vida da maioria dos animais neste estudo. Assim, sugere-se que doses mais baixas de lomustina sejam consideradas em estudos futuros(AU)
Asunto(s)
Animales , Perros , Lomustina/uso terapéutico , Lomustina/efectos adversos , Lomustina/toxicidad , Neoplasias Cutáneas/terapia , Neoplasias Cutáneas/veterinaria , Diagnóstico Clínico/veterinariaRESUMEN
The aim of this prospective study was to evaluate the clinical response of dogs with cutaneous lymphoma treated with lomustine (CCNU) and to identify possible adverse effects and toxicity during treatment. Fifteen dogs, seven females and eight males aged between five and 17 years old, diagnosed with cutaneous lymphoma by histopathological analysis were selected and treated with lomustine at 90 mg/m² every three weeks. Monitoring was carried out and consisted of the assessment of laboratory hematology and serum chemistry before and during treatment. Partial response was observed in 53.3% of the animals. None of the animals achieved a complete response and seven dogs (46.6%) had progressive disease. The median survival time was 22 days. The major hematological and biochemical changes found after therapy were leukopenia (73.3%), thrombocytopenia (60%) and anemia (46.1%). Renal and liver toxicity was observed in 40% and 73.3% of dogs, respectively. Hematocrit, total protein, leukocyte count, neutrophil count, serum creatinine, ALT, GGT, alkaline phosphatase and urine specific gravity were affected during therapy. The use of lomustine as a monotherapy in the treatment of canine cutaneous lymphoma was effective; however, adverse effects occurred and compromised the quality of life of the majority of dogs in this study. Therefore, lower doses of lomustine should be considered in future studies...
O objetivo deste estudo prospectivo foi avaliar a resposta clínica de cães com linfoma cutâneo tratados com lomustina (CCNU) e identificar possíveis efeitos adversos e toxicidade durante o tratamento. Quinze cães, sendo 7 fêmeas e 8 machos, com idades entre 5 e 17 anos diagnosticados com linfoma cutâneo por avaliação histopatológica foram selecionados e tratados com lomustina na dose de 90 mg/m2 a cada três semanas. Os cães foram monitorados por avaliação hematológica e bioquímica sérica antes e durante o tratamento. A resposta parcial foi observada em 53,3% dos animais. Nenhum dos animais apresentou resposta completa e sete animais (46,6%) apresentaram progressão da doença. O tempo médio de sobrevida foi de 22 dias. As principais alterações hematológicas e bioquímicas observadas após o tratamento foram leucopenia (73,3%), trombocitopenia (60%) e anemia (46,1%). Sinais de toxicidade renal e hepática foram observados em 40% e 73,3% dos cães, respectivamente. Durante o tratamento foram afetados os parâmetros hematócrito, proteínas séricas totais, contagem de leucócitos, contagem de neutrófilos, creatinina sérica, ALT, GGT, fosfatase alcalina e densidade urinária. O uso de lomustina como monoterapia no tratamento do linfoma cutâneo canino foi efetivo; entretanto, efeitos adversos ocorreram e comprometeram a qualidade de vida da maioria dos animais neste estudo. Assim, sugere-se que doses mais baixas de lomustina sejam consideradas em estudos futuros...
Asunto(s)
Animales , Perros , Lomustina/efectos adversos , Lomustina/toxicidad , Lomustina/uso terapéutico , Neoplasias Cutáneas/terapia , Diagnóstico Clínico/veterinaria , Neoplasias Cutáneas/veterinariaRESUMEN
BACKGROUND: Nonresectable mast cell tumors (MCT) in dogs remain a therapeutic challenge, and investigation of novel combination therapies is warranted. Intermittent administration of tyrosine kinase inhibitors (TKI) combined with cytotoxic chemotherapy may effectively chemosensitize canine MCT while decreasing cost and adverse effects associated with either agent administered as monotherapy. HYPOTHESIS/OBJECTIVES: The primary study objectives were to (1) identify the maximally tolerated dose (MTD), (2) determine the objective response rate (ORR) and (3) describe the adverse event profile of pulse-administered toceranib phosphate (TOC) combined with lomustine. ANIMALS: Forty-seven client-owned dogs with measurable MCT. METHODS: Toceranib phosphate was given PO on days 1, 3 and 5 of a 21-day cycle at a target dosage of 2.75 mg/kg. Lomustine was given PO on day 3 of each cycle at a starting dosage of 50 mg/m(2) . All dogs were concurrently treated with diphenhydramine, omeprazole, and prednisone. RESULTS: The MTD of lomustine was established at 50 mg/m(2) when combined with pulse-administered TOC; the dose-limiting toxicity was neutropenia. Forty-one dogs treated at the MTD were evaluable for outcome assessment. The ORR was 46% (4 complete response, 15 partial response) and the overall median progression-free survival (PFS) was 53 days (1 to >752 days). On multivariate analysis, variables significantly associated with improved PFS included response to treatment, absence of metastasis, and no previous chemotherapy. CONCLUSIONS AND CLINICAL IMPORTANCE: Combined treatment with pulse-administered TOC and lomustine generally is well tolerated and may be a reasonable treatment option for dogs with unresectable or metastatic MCT.
Asunto(s)
Antineoplásicos Alquilantes/uso terapéutico , Enfermedades de los Perros/tratamiento farmacológico , Indoles/uso terapéutico , Lomustina/uso terapéutico , Mastocitosis/veterinaria , Proteínas Tirosina Quinasas/antagonistas & inhibidores , Pirroles/uso terapéutico , Animales , Antineoplásicos Alquilantes/administración & dosificación , Enfermedades de los Perros/genética , Perros , Esquema de Medicación/veterinaria , Quimioterapia Combinada , Femenino , Indoles/administración & dosificación , Lomustina/administración & dosificación , Masculino , Mastocitosis/tratamiento farmacológico , Mastocitosis/genética , Reacción en Cadena de la Polimerasa/veterinaria , Proteínas Proto-Oncogénicas c-kit/genética , Pirroles/administración & dosificaciónRESUMEN
The purpose of this prospective phase II/III trial was to study the effect of therapy intensification when combining procarbazine, lomustine, and vincristine (PCV) chemotherapy with a standard course of radiation therapy (RT) on cognitive functioning for patients with World Health Organization grade 2 low-grade gliomas (LGGs). Initial results of the trial demonstrated a progression-free survival benefit with adjuvant PCV, but no overall survival benefit in the intention-to-treat analysis. Because patients with LGGs have favorable prognostic indicators, the five-year overall survival rates range from 60%-70%. The effect of cancer treatment on neurocognitive function is a topic of increasing interest to healthcare providers and patients. The negative effect is commonly called "chemobrain" and refers to diminished concentration and compromised short-term memory following treatment. Chemobrain has been studied in other populations of patients with cancer (e.g., breast cancer) with associated statistically significant chemotherapy-associated compromised cognitive function when chemotherapy was added to RT.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/radioterapia , Glioma/tratamiento farmacológico , Glioma/radioterapia , Adulto , Anciano , Anciano de 80 o más Años , Quimioterapia Adyuvante/efectos adversos , Trastornos del Conocimiento/inducido químicamente , Femenino , Humanos , Lomustina/efectos adversos , Lomustina/uso terapéutico , Masculino , Persona de Mediana Edad , Procarbazina/efectos adversos , Procarbazina/uso terapéutico , Estudios Prospectivos , Vincristina/efectos adversos , Vincristina/uso terapéutico , Adulto JovenRESUMEN
A lomustina é um agente quimioterápico que vem sendo utilizado no tratamento do mastocitomacanino. Este trabalho tem o objetivo de avaliar os efeitos mielotóxicos induzidos por essa droga duranteo tratamento. Foram avaliados seis cães com mastocitoma utilizando lomustina. Três cães foramtratados de forma adjuvante a cirurgia, sendo dois de grau II e um de grau III e três cães de formapaliativa de grau III. Foram realizados exames clínicos gerais, hemograma completo, dosagem séricade alalino aminotransferase (ALT), fosfatase alcalina, ureia e creatinina. Dois cães apresentaram mielossupressão,com leucopenia e neutrofi lia, na primeira semana após a quimioterapia, retornando aosvalores normais na terceira semana, sem apresentar febre. Foi iniciado antibioticoterapia em ambosos animais e a dosagem posterior de lomustina foi reduzida em 30%. Os demais exames não apresentaramalterações. Os efeitos colaterais do tratamento do mastocitoma com lomustina se mostraramaceitáveis, havendo a necessidade de acompanhamento hematológico e bioquímico desses animais
The lomustine is a chemotherapic agent that has been used in the treatment of canine mast cell tumor.The odd of this paper is evaluate the myelosuppression caused by lomustine in the treatment of Mastcell Tumor (MCT) in dogs. Three dogs were treated with surgery and adjuvante chemotherapy, beingtwo grade II and one grade III and three dogs with grade III were treated with palliative chemotherapy.It was realized haemogram and plasm dosage of alanine aminotransferase, alkaline phosphatase,creatinine and urea. Two dogs presented myelossuppression with leukopenia and neutropenia in thefi rst week after the chemotherapy, returning to the normal value in the third week, without fever. Theboth dogs were treated with antibiotic therapy and the posterior dosage of lomustine was reduced in30%. The others exams didnt presented any alteration. The adverse effect of the treatment of MCTwith lomustine showed acceptable and the patients have to be monitoring with haematological and biochemistry of these animals
Asunto(s)
Animales , Perros , Perros , Lomustina/efectos adversos , Lomustina/toxicidad , Lomustina/uso terapéutico , Mastocitoma/tratamiento farmacológico , Mastocitoma/veterinariaRESUMEN
A lomustina é um agente quimioterápico que vem sendo utilizado no tratamento do mastocitomacanino. Este trabalho tem o objetivo de avaliar os efeitos mielotóxicos induzidos por essa droga duranteo tratamento. Foram avaliados seis cães com mastocitoma utilizando lomustina. Três cães foramtratados de forma adjuvante a cirurgia, sendo dois de grau II e um de grau III e três cães de formapaliativa de grau III. Foram realizados exames clínicos gerais, hemograma completo, dosagem séricade alalino aminotransferase (ALT), fosfatase alcalina, ureia e creatinina. Dois cães apresentaram mielossupressão,com leucopenia e neutrofi lia, na primeira semana após a quimioterapia, retornando aosvalores normais na terceira semana, sem apresentar febre. Foi iniciado antibioticoterapia em ambosos animais e a dosagem posterior de lomustina foi reduzida em 30%. Os demais exames não apresentaramalterações. Os efeitos colaterais do tratamento do mastocitoma com lomustina se mostraramaceitáveis, havendo a necessidade de acompanhamento hematológico e bioquímico desses animais(AU)
The lomustine is a chemotherapic agent that has been used in the treatment of canine mast cell tumor.The odd of this paper is evaluate the myelosuppression caused by lomustine in the treatment of Mastcell Tumor (MCT) in dogs. Three dogs were treated with surgery and adjuvante chemotherapy, beingtwo grade II and one grade III and three dogs with grade III were treated with palliative chemotherapy.It was realized haemogram and plasm dosage of alanine aminotransferase, alkaline phosphatase,creatinine and urea. Two dogs presented myelossuppression with leukopenia and neutropenia in thefi rst week after the chemotherapy, returning to the normal value in the third week, without fever. Theboth dogs were treated with antibiotic therapy and the posterior dosage of lomustine was reduced in30%. The others exams didnt presented any alteration. The adverse effect of the treatment of MCTwith lomustine showed acceptable and the patients have to be monitoring with haematological and biochemistry of these animals(AU)
Asunto(s)
Animales , Perros , Lomustina/efectos adversos , Lomustina/toxicidad , Lomustina/uso terapéutico , Mastocitoma/tratamiento farmacológico , Mastocitoma/veterinaria , PerrosRESUMEN
Se analiza la evolución de 157 pacientes (97 varones) con diagnóstico histológico de astrocitoma anaplásico (AA, N=53), astrocitoma de bajo grado (ABG, N=31) y glioblastoma (GB, N=73) sometidos a tratamiento multidisciplinario. Los pacientes con AA, GB y ABG con resecciones parciales (RP) o recidiva realizaron cirugía, radioterapia y/o quimioterapia (lomustina, vincristina y procarbazina). Los ABG con resección completa (RC) efectuaron sólo cirugía. La edad X ñ ES fue 49,71 ñ 1,9 para AA; 39,19 ñ 2,4 para ABG y 59,13 ñ 1,3 para GB (p < 0,0001). Un Karnofsky > 70 por ciento se observó en el 84,90 por ciento AA; 90,32 por ciento ABG y 38,35 por ciento GB. El número de RC fue: 64,15 por ciento para AA; 61,29 por ciento ABG y 23,28 por ciento GB. Se encontraron diferencias significativas entre la edad, Karnofsky y tipos de cirugía de los distintos tipos histológicos. La sobrevida media SV para AA fue 30,02 meses (IC 95 por ciento 25,99-34,05); 43,32 meses (IC 95 por ciento 36,82-49,83) para ABG y 10,20 meses (IC 95 por ciento 9,28-11,12) para GB. La sobrevida se correlacionó con edad, Karnofsky y tipo de cirugía (p<0,0001) en pacientes AA y con Karnofsky en pacientes GB (p<0,0001). Cuando se analizó la sobrevida de los diferentes tipos histológicos en función de la cirugía y del Karnofsky se observó mayor sobrevida en los pacientes con RC y Karnofsky > 70 por ciento (p<0,0001, Log rank test). Sólo en 10 pacientes la toxicidad correspondió al grado 3 de la OMS y ningún caso requirió modificación de la dosis. En concordancia con otras comunicaciones la evolución de los AA fue mejor que la de los GB. La mayor frecuencia de resecciones completas, el mejor Karnofsky y la menor edad pueden contribuir con éstos resultados. La mejor evolución de los pacientes con ABG dependería más del tipo histológico que de las otras variables consideradas (AU)
Asunto(s)
Humanos , Masculino , Adolescente , Adulto , Femenino , Persona de Mediana Edad , Anciano , Astrocitoma/tratamiento farmacológico , Glioblastoma/tratamiento farmacológico , Astrocitoma/radioterapia , Astrocitoma/cirugía , Glioblastoma/radioterapia , Glioblastoma/cirugía , Glioma/radioterapia , Glioma/cirugía , Neoplasias Encefálicas , Resultado del Tratamiento , Procarbazina/uso terapéutico , Procarbazina/administración & dosificación , Vincristina/uso terapéutico , Vincristina/administración & dosificación , Lomustina/uso terapéutico , Lomustina/administración & dosificación , Análisis de Supervivencia , Estado de Ejecución de KarnofskyRESUMEN
A total of 277 patients with untreated Hodgkin's disease, clinical stages I-II, were randomized to cyclophosphamide, vinblastine, procarbazine, and prednisone (CVPP) alone for 6 monthly cycles or to CVPP plus radiation therapy (RT), 3,000 rad, to involved areas (CVPP plus RT). One or more of the following factors were considered as unfavorable prognosis: age greater than 45 years, more than two lymph node areas involved, or bulky disease. In the favorable group, disease-free survival (77% vs. 70%) or overall survival (92% vs. 91%) at 84 months for CVPP versus RT plus CVPP was similar. Patients with unfavorable prognosis treated with RT plus CVPP had longer disease-free survival (75% vs. 34%) (P = .001) and overall survival (84% vs. 66%) than patients treated with CVPP alone.