2018-08-082024-05-16https://scholars.lib.ntu.edu.tw/handle/123456789/666927摘要：淋巴瘤占犬隻所有腫瘤的五分之一，也是最常見的惡性血液腫瘤。因為和人類的非何杰金氏淋巴瘤(non-Hodgkin’s lymphoma)有許多相似之處，因此可做為人醫的借鏡。 合併式的化學治療已經是犬淋巴瘤的標準治療選擇，其中又以合併環磷醯胺(cyclophosphamide)、阿黴素(doxorubicin)、長春新鹼(vincristine)和皮質類固醇(prednisolone)的療程(CHOP protocol)最為獸醫師所採用。依據我們於2016年發表的研究(DOI:10.1016/j.tvjl.2016.04.013)中顯示，淋巴瘤的犬隻最易在給予環磷醯胺後復發，顯示此藥物對於腫瘤的控制效果最差。此藥又容易引起骨髓抑制及無菌性出血性膀胱炎，使得後續治療需要延遲，同時增加病患的不適。因此可以考慮將此藥物以其它化療藥物取代，延長疾病治癒期及存活時間。天門冬醯胺&#37238;(L-asparaginase)能分解血液中的天門冬醯胺，所以可以使需要天門冬醯胺的腫瘤細胞缺乏營養供給而死亡，進而達到抗癌的效果。此藥物也已證明可以應用在犬淋巴瘤的治療上。由於腫瘤消退時間會隨著抗藥性的生成及腫瘤的復發而減少，因此若能延長初次疾病治癒期，就可以更長久的控制此疾病。本研究會在傳統CHOP療程中，以天門冬醯胺&#37238;取代環磷醯胺，評估是否可以延長初次疾病治癒期及存活時間，同時比較兩種藥物引起的副作用，期望能提升治療的成效，應用在人類淋巴腫瘤治療的參考。<br> Abstract: Lymphoma is the most common malignant hematopoietic tumor in dogs, and comprises approximately one-fifth of all canine neoplasia. This disease is similar to non-Hodgkin’s lymphoma in human beings; therefore, it may be a good reference for human medicine. Combination chemotherapy is the standard treatment of choice for canine lymphoma. The CHOP protocol, which include cyclophosphamide, doxorubicin, vincristine and prednisolone, is the most commonly used treatment protocol by veterinarians. According to our previous published research(DOI:10.1016/j.tvjl.2016.04.013), lymphoma relapse most commonly after cyclophosphamide administration in dog, suggest that cyclophosphamide has the least cytotoxic effect. Besides, cyclophosphamide is prone to induce bone marrow suppression and sterile hemorrhagic cystitis, result in delayed follow-up treatment and increased patient’s uncomfortable. For this reason, we consider to replace cyclophosphamide with other chemotherapeutic drug to increase remission duration and survival time.L-asparaginase can induce apoptosis of tumor cells by breaking down asparagine, an essential amino acid for tumor growth, in the blood. The drug has already been proven to use in canine lymphoma treatment. The duration of tumor remission will decrease as the drug resistant occurred and tumor relapsed.Therefore, then longer remission time we can achieve, the better control we can make in this disease. This study will use l-asparaginase to replace cyclophosphamide in traditional CHOP protocol, and evaluate whether a longer first remission duration and survival time. We will also compare the side effects between these two drugs, and hope to elevate treatment efficacy. The result may apply in human lymphoma treatment in the future.犬淋巴瘤環磷醯胺天門冬醯胺&#37238化學治療caninelymphomacyclophosphamideL-asparaginasechemotherapy