Clinical and laboratorial evaluation of dogs with cutaneous lymphoma treated with lomustine

Abstract

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. Keywords: CCNU. Cutaneous lymphoma. Dogs. Oncology. Adverse effects. ResumoO 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.

Serum levels of soluble interleukin-2 receptor (sIL-2R) and cancer antigen 125 (CA 125) in dogs diagnosed with cutaneous lymphoma

“…The average survival time of dogs with cutaneous lymphoma was 27 days. The low average survival of patients with cutaneous lymphoma and the higher incidence of the non-epitheliotropic form corroborate the study by Duarte et al (2016). Notably, 6 of the 15 animals in this group (40%) died before the conclusive diagnosis of cutaneous lymphoma due to disease progression, 5 animals were not submitted to chemotherapy because of their clinical conditions and/or the tutor's resolution, and 4 animals began chemotherapy.…”

“…Cutaneous lymphoma incidence appears to be higher in Brazil, although epidemiological studies are lacking (Duarte et al, 2016). Cutaneous lymphomas can develop with a poor prognosis due to disease aggressiveness, rapid clinical progression and reduced survival in both epitheliotropic and non-epitheliotropic forms (Moore et al, 2013;Chan et al, 2018).…”

Metastatic T-cell lymphoma of unknown primary origin in a dog (Canis lupus familiaris)

“…The cutaneous lesions evidenced in the animal in question are related to the cutaneous form of the lymphoma, which is characterized by the formation of plaques and/or multifocal or even generalized skin nodules (DUARTE et al, 2016). Neoplastic infiltration in the lower respiratory tract was also observed in the reported animal, generating a condition of chronic obstructive pulmonary disease (COPD), which is characterized by a chronic and continuous restriction of the gas flow to the airways, triggering the clinical signs (POSADA; MONKS; CASTRO, 2014), which justified the presence of cough and respiratory distress.…”