Peer-reviewed veterinary case report
How 10% chemo dose cuts and delays affect low white cells in dogs
By Busser, Suzanne et al.·Published in Veterinary and comparative oncology·2024·The Royal (Dick) School of Veterinary Studies, United Kingdom·View original on PubMed →
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Original publication title: Impact of 10% Dose Reductions and Duration of Treatment Delays in the Management of Chemotherapy-Induced Neutropenia in Dogs Treated With Common Chemotherapy Protocols: A Single-Centre Experience.
- Species:
- dog
Plain-English summary
A group of dogs undergoing chemotherapy developed a condition called neutropenia, which means they had low levels of a type of white blood cell that helps fight infections. To manage this, veterinarians tried reducing the chemotherapy dose by 10% and found that this approach worked for many dogs, with over half achieving acceptable white blood cell counts after just one dose reduction. However, some dogs still experienced low white blood cell counts despite the reduction, particularly those treated with certain drugs like lomustine and cyclophosphamide. The duration of treatment delays did not seem to affect the chances of developing neutropenia again.
People also search for: dog chemotherapy side effects · neutropenia in dogs treatment · chemotherapy dose reduction for dogs
Abstract
Neutropenia is a common chemotherapy-associated adverse event (AE) in dogs and a significant cause of decreased relative dose intensity. Dose reductions (DRs) and treatment delays (TDs) are frequently applied to decrease the risk of further neutropenic events (NEs) and AEs, but there is no standardised approach. The two main objectives of this retrospective study were to determine: (1) the failure rate of a 10% DR to prevent a subsequent inadequate absolute neutrophil count (ANC), defined as a nadir ANC <0.75 × 10/L or pretreatment ANC <1.5 × 10/L; and (2) if the duration of TDs due to pretreatment neutropenia affects the occurrence of subsequent NEs. A total of 1056 chemotherapy treatments were recorded for 128 dogs that developed at least one NE. In 75 of 124 (60.5%, 95% CI: 51.2%-69%) evaluable NEs, a nadir ANC of ≥0.75 × 10/L and pretreatment ANC of ≥1.5 × 10/L were achieved after a single 10% chemotherapy DR, while a 10% DR failed to prevent a subsequent inadequate ANC in the remaining 49/124 (39.5%, 95% CI: 30.1%-48.3%). The only variable associated with failure was the drug prescribed. DR failure occurred in 22/39 (56.4%, 95% CI: 40.9%-70.6%) lomustine DRs, 14/27 (51.9%, 95% CI: 33.9%-69.2%) cyclophosphamide DRs, but only 2/22 (9.1%, 95% CI: 2.5%-27.8%) doxorubicin DRs and 2/24 (8.3%, 95% CI: 2.3%-25.8%) vincristine DRs. Seventy-three evaluable TDs (mean: 5 days, SD ± 2.2 days) were prescribed. There was no association between TD duration and subsequent NEs (p = 0.11).
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/39168816/