Uso de lomustina em linfoma gastrointestinal felino : revisão de literatura e descrição de 3 casos clínicos
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2021
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Esta dissertação foi realizada no âmbito da conclusão do Mestrado Integrado em
Medicina Veterinária da Universidade Lusófona de Humanidades e Tecnologias e teve
como principal objetivo o desenvolvimento do tema Linfoma Gastrointestinal Felino e
tratamento com lomustina. Compreende uma revisão bibliográfica extensa sobre o tema
em questão e a apresentação e discussão de 3 casos clínicos.
O linfoma consiste num grupo heterogéneo de neoplasias de origem
hematopoiética que exibem morfologia variável e uma multitude de apresentações
clínicas e anatómicas, exigindo a aplicação de diversas abordagens diagnósticas, assim
como distintas modalidades terapêuticas.
Nos últimos anos, a incidência de linfoma gastrointestinal felino tem vindo a
aumentar, sendo o tumor gastrointestinal mais frequentemente diagnosticado no gato. O
prognóstico é variável e encontra-se dependente de vários fatores, tais como a graduação,
o estadiamento e a terapêutica implementada.
Na presente dissertação, são expostos três casos com apresentação clínica de
linfoma gastrointestinal, em que todos os pacientes foram submetidos a tratamento com
lomustina. Este fármaco foi administrado na forma de cápsulas por via oral e foi
implementado tanto como agente de resgate como terapêutica de mono-fármaco. Num
dos casos, o paciente manteve doença estável com o plano terapêutico instituído até aos
232 dias de follow-up. No segundo caso, durante o curso do tratamento ocorreu ligeira
progressão de doença, no entanto, no decurso do tratamento manteve doença estável até
à data limite de follow-up. Apenas num dos casos descritos ocorreu progressão da doença
e posterior infiltração para outros órgãos, o que resultou na mudança de protocolo
quimioterápico.
O principal desafio de pacientes com linfoma felino encontra-se relacionado com
a precocidade do diagnóstico, estabilização e ajuste da medicação tendo como principal
objetivo, sempre que possível, obter a remissão da doença, nunca descuidando do
conforto e bem-estar dos pacientes.
This dissertation was written with the aim of completing the Integrated Master’s Degree in Veterinary Medicine of Universidade Lusófona de Humanidades e Tecnologias. This report discusses Feline Gastrointestinal Lymphoma treated with lomustine. It also includes an extensive bibliographic review of this topic, as well as an in-depth presentation and discussion of 3 case-studies. Lymphoma consists in a group of heterogenous hematopoietic neoplasia that usually exhibit variable morphology and clinical presentation, thus requiring complex diagnostic approaches and distinct therapeutic modalities. The incidence of gastrointestinal lymphoma has been on the rise. Nowadays, lymphoma is considered the tumor with higher prevalence located in the gastrointestinal system of the cat. The prognosis is usually variable and dependent on multiple factors such as the tumor grade, progression of the disease and therapeutic options applied. This report, includes three cases of patients with clinical presentation of feline gastrointestinal lymphoma treated with lomustine. Lomustine was given in the form of oral capsules and applied as a chemotherapeutic rescue agent or as single drug protocol. In one of the cases, the animal remained stable throughout the duration of the therapeutic plan until the last follow-up (232 days). On the other hand, in one case there was slight disease progression, however during the course of treatment until the last follow-up, the patient remained stable. In only one cat occurred disease progression and infiltration to other organs that required an amendment in the chemotherapeutic protocol. The main constraint of patients with feline gastrointestinal lymphoma is associated with and early diagnosis, stabilization and adjustment of the therapeutic plan. The main purpose of the treatment is to attain a complete disease remission although always taking in account the well-being of the patients.
This dissertation was written with the aim of completing the Integrated Master’s Degree in Veterinary Medicine of Universidade Lusófona de Humanidades e Tecnologias. This report discusses Feline Gastrointestinal Lymphoma treated with lomustine. It also includes an extensive bibliographic review of this topic, as well as an in-depth presentation and discussion of 3 case-studies. Lymphoma consists in a group of heterogenous hematopoietic neoplasia that usually exhibit variable morphology and clinical presentation, thus requiring complex diagnostic approaches and distinct therapeutic modalities. The incidence of gastrointestinal lymphoma has been on the rise. Nowadays, lymphoma is considered the tumor with higher prevalence located in the gastrointestinal system of the cat. The prognosis is usually variable and dependent on multiple factors such as the tumor grade, progression of the disease and therapeutic options applied. This report, includes three cases of patients with clinical presentation of feline gastrointestinal lymphoma treated with lomustine. Lomustine was given in the form of oral capsules and applied as a chemotherapeutic rescue agent or as single drug protocol. In one of the cases, the animal remained stable throughout the duration of the therapeutic plan until the last follow-up (232 days). On the other hand, in one case there was slight disease progression, however during the course of treatment until the last follow-up, the patient remained stable. In only one cat occurred disease progression and infiltration to other organs that required an amendment in the chemotherapeutic protocol. The main constraint of patients with feline gastrointestinal lymphoma is associated with and early diagnosis, stabilization and adjustment of the therapeutic plan. The main purpose of the treatment is to attain a complete disease remission although always taking in account the well-being of the patients.
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Orientação: Nazaré Cunha
Palavras-chave
MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, MEDICINA VETERINÁRIA, VETERINÁRIA, FELÍDEOS, GATOS, LINFOMA, SISTEMA DIGESTIVO, QUIMIOTERAPIA, NEOPLASIAS, CASOS CLÍNICOS, VETERINARY MEDICINE, FELIDS, CATS, LYMPHOMA, DIGESTIVE SYSTEM, CHEMOTHERAPY, NEOPLASMS, CASE REPORTS, LOMUSTINE, LOMUSTINA