Ocena skuteczności terapii opartej na protokole wielolekowej chemioterapii podtrzymującej (CHOP-MA) bazującej na mitoksantronie w leczeniu chłoniaka u psów. Cz. II
Evaluation of a multidrug chemotherapy protocol with mitoxantrone based maintenance (CHOP-MA) for the treatment of canine lymphoma. Part II
The primary goal of this study was to determine if additional doses of mitoxantrone impacted remission time when compared with historical CHOP-based chemotherapy protocols. Preliminary data from a previous study suggested that a CHOP-based protocol incorporating six doses of doxorubicin was highly effective, but clinical cases of cardiotoxicity were noted (Meleo, personal communication). Results of the present study suggest that the substitution of mitoxantrone into a traditional CHOP-based chemotherapy protocol during a maintenance phase may also improve overall remission time for dogs with multicentric lymphoma. However, the use of mitoxantrone does not appear to contribute to a higher level of gastrointestinal, bone marrow or cardiac toxicity.
Mitoxantrone causes cytotoxicity by many of the same mechanisms as doxorubicin. It is foreseeable, then, that increasing the exposure of lymphoma cells to these mechanisms would also improve cyto-toxicity. Recently, however, mitoxantrone has been used in certain cases of multiple sclerosis with inflammatory disease activity. Studies involving these inflammatory cases of multiple sclerosis have shown that mitoxantrone, in addition to its cyto-toxic effects, also possesses immunomodulatory activity. Specifically, it has been shown to decrease γ-interferon, tumour necrosis factor-α and interleukin-2 levels (16). In a dose-dependent manner, mitoxantrone has also been shown to induce apop-tosis in B-lymphocytes and monocytes(17, 18). The addition of these immunomodulatory effects to the traditional [...]
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