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Case Reports
. 2023 Dec;64(12):1103-1108.

Doxorubicin and zoledronate treatment in a dog with hemophagocytic histiocytic sarcoma

Aimée M Soileau  1 , Rachel L A L T Neto  1 , Patricia Titos Jimenez  1 , Jack Hamersky  1 , Ashley A Smith  1
Affiliations
Case Reports

Doxorubicin and zoledronate treatment in a dog with hemophagocytic histiocytic sarcoma

Aimée M Soileau et al. Can Vet J. 2023 Dec.

Abstract
in English, French

A 6-year-old castrated male greyhound dog was referred for hemophagocytic histiocytic sarcoma (HHS) diagnosed following splenectomy. Severe thrombocytopenia, mild hypoalbuminemia, mild hypocholesterolemia, and mild hyperbilirubinemia were present. Abdominal ultrasound findings were concerning for hepatic metastasis. Doxorubicin and zoledronate combination therapy was initiated. The dog improved clinically and its thrombocytopenia, hypoalbuminemia, and hyperbilirubinemia resolved. The dog appeared well for 147 d before tumor progression was noted. The dog was treated with lomustine as a final measure, with no response. The dog survived for 6 mo with chemotherapy. To the authors' knowledge, this is the first report of clinical benefit of chemotherapy for HHS. Key clinical message: Doxorubicin should be considered for treating canine HHS since this variant of the disease is historically refractory to lomustine. Further research regarding efficacy of doxorubicin and zoledronate should be pursued.

Traitement à la doxorubicine et au zolédronate chez un chien atteint de sarcome histiocytaire hémophagocytaire. Un lévrier mâle castré de 6 ans a été vu pour un sarcome histiocytaire hémophagocytaire (HHS) diagnostiqué à la suite d’une splénectomie. Une thrombopénie sévère, une hypoalbuminémie légère, une hypocholestérolémie légère et une hyperbilirubinémie légère étaient présentes. Les résultats de l’échographie abdominale étaient préoccupants quant aux métastases hépatiques. Un traitement associant doxorubicine et zolédronate a été instauré. Le chien s’est amélioré cliniquement et sa thrombocytopénie, son hypoalbuminémie et son hyperbilirubinémie ont disparu. Le chien semblait en bonne santé pendant 147 jours avant de constater une progression tumorale. Le chien a été traité avec de la lomustine comme mesure finale, sans réponse. Le chien a survécu 6 mois grâce à la chimiothérapie. À la connaissance des auteurs, il s’agit du premier rapport faisant état d’un bénéfice clinique de la chimiothérapie pour le HHS.Message clinique clé :La doxorubicine doit être envisagée pour traiter le HHS canin puisque cette variante de la maladie est historiquement réfractaire à la lomustine. Des recherches plus approfondies concernant l’efficacité de la doxorubicine et du zolédronate devraient être poursuivies.(Traduit par Dr Serge Messier).

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Figures

Figure 1
Figure 1
Timeline of chemotherapy treatments and clinical findings. CCNU — Lomustine; DOX — Doxorubicin; HHS — Hemophagocytic histiocytic sarcoma; LN — Lymph node; ZOL — Zoledronate.
Figure 2
Figure 2
Initial ultrasound image of the liver. The hepatic parenchyma is markedly heterogenous and contains multiple hypoechoic nodules (arrows). Field of view = 7 cm.
Figure 3
Figure 3
Photomicrograph of spleen tissue, with sheets of large, epithelioid cells expanding the congested red pulp (arrows), abutting the white pulp (star). Hematoxylin and eosin, 20× magnification.
Figure 4
Figure 4
Photomicrograph of spleen tissue. Neoplastic cells are polygonal-to-rounded, with abundant flocculent cytoplasm, and frequent engulfed erythrocytes and hemosiderin (arrows). This cell population is mitotically active (arrowhead) and has moderate anisocytosis and anisokaryosis. Hematoxylin and eosin, 40× magnification.
Figure 5
Figure 5
Immunohistochemistry. Diffusely, sheets of neoplastic cells have strong cytoplasmic immunolabeling (brown) for ionized calcium binding adaptor molecule 1 (Iba1). Ionized calcium binding adaptor molecule 1 immunohistochemistry, 10× magnification.
See this image and copyright information in PMC

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