Ocena skuteczności terapii opartej na protokole wielolekowej chemioterapii podtrzymującej (CHOP-MA) bazującej na mitoksantronie w leczeniu chłoniaka u psów. Cz. II
The results of this study support further evaluation of the benefits of increasing the combined total dose of doxorubicin and mitoxantrone for the treatment of canine lymphoma. Recent literature has suggested that shorter maintenance-free and consolidation-free CHOP-based protocols are comparable with longer protocols that include either one or both phases(6, 19-21). This study neither supports nor disproves this theory as the combined dose of doxorubicin and mitoxantrone is higher than that used in any previous type of CHOP-based protocol. Further studies that assess the effect of incorporating mitoxantrone earlier in the induction phases while eliminating maintenance and consolidation phases would be needed to differentiate the benefits of short versus long CHOP-MA type protocols. Currently, a major disadvantage with the use of mitoxantrone is its high cost and relatively short shelf life. Although preservation of antineoplastic effect has been demonstrated after repeated freeze–thaw cycles (28), using mitoxantrone in a shorter CHOP-based protocol would also help off-set the added expense of a long protocol that incor-porates maintenance and consolidation phases.
In conclusion, the results of this study provide evidence that increasing the total combined dose of doxorubicin and mitoxantrone may improve remission times in dogs with multicentric lymphoma compared with traditional CHOP-based protocols. It also calls into question some of the purported drawbacks of maintenance chemotherapy for the treatment of this disease. Prospective, randomized studies are needed to objectively compare the efficacy of the relatively long protocol described here with shorter CHOP-based protocols [...]
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