Ocena skuteczności terapii opartej na protokole wielolekowej chemioterapii podtrzymującej (CHOP-MA) bazującej na mitoksantronie w leczeniu chłoniaka u psów. Cz. II
One theoretic concern regarding CHOP or other chemotherapy protocols that incorporate a maintenance phase is a potential lack of response to rescue protocols once dogs come out of remission. This could occur because of the increased frequency and duration of exposure of lymphoma cells to the CHOP drugs, leading to subsequent development of more significant multidrug resistance. In the cur-rent study, 39 dogs received rescue therapy at some point, either during the CHOP-MA protocol (25 or 64%) or after conclusion of the CHOP-MA proto-col (14 or 36%). Of those dogs who were rescued during the CHOP-MA protocol, 23 (92%) achieved either a complete or partial secondary remission. Of those dogs that had completed the CHOP-MA protocol, 14 (100%) achieved either a complete or partial secondary remission. The ability of these res-cue protocols to induce remissions at rates similar to or better than those of previous reports (65–72%) suggests that neither the maintenance phase nor the addition of mitoxantrone to this protocol resulted in additional multidrug resistance when compared with previously published CHOP-based protocols, whether or not they incorporated a maintenance phase(22, 23).
Other factors unrelated to the treatment protocol itself may have contributed to the apparent efficacy of CHOP-MA in this study. One factor is the study population itself. Dogs with atypical lym-phoma (ocular alone, gastrointestinal alone, central nervous system, cutaneous, mediastinal alone, etc.) were excluded from this analysis. Historically, these are animals that generally perform poorly with regards to obtaining [...]
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