Tyrosine kinase inhibitors as an alternative treatment in canine mast cell tumor.

The current gold standard treatment for canine mast cell tumors (MCT) uses vinblastine sulfate (VBL) as chemotherapy, although tyrosine kinase inhibitors (TKI) have recently been shown to be worthy candidates for treatment. This systematic review aimed to analyze the overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and complete (CR) or partial response (PR) in dogs with MCT treated with TKI compared to standard VBL treatment. The systematic review was registered in the Open Science Framework (OSF) database under the identifier 10.17605/OSF.IO/WYPN4 (https://osf.io/). An electronic search was performed in nine databases. References from eligible studies were also selected to find more registers. A total of 28 studies met the eligibility criteria, and one more was recovered from the references of eligible studies, totaling 29 selected studies. The overall response rate, complete response, and partial response were higher in dogs treated with tyrosine kinase inhibitors than in dogs treated with vinblastine. The overall survival and progression-free survival of vinblastine-treated dogs were higher compared to tyrosine kinase inhibitors-treated dogs. Dogs with mutated KIT treated with tyrosine kinase inhibitors have longer overall survival and progression-free survival compared to those treated with vinblastine. It is important to consider the limitation of the study which should temper the interpretation of the results, videlicet, the extracted data lacked sample standardization and included variables such as animal characteristics, mutation detection methods, tumor characteristics, and treatment types which may have influenced the outcome of the study. Systematic review registration: https://osf.io/, identifier: 10.17605/OSF.IO/WYPN4.

Imatinib Mesylate for the Treatment of Canine Mast Cell Tumors: Assessment of the Response and Adverse Events in Comparison with the Conventional Therapy with Vinblastine and Prednisone.

Mast cell tumors (MCTs) are common neoplasms in dogs, and treatments for these diseases include surgery, polychemotherapy and targeted therapy with tyrosine kinase inhibitors. This study aimed to evaluate the response and the adverse events of treatment with imatinib mesylate (IM) compared to conventional therapy using vinblastine and prednisolone (VP) in canine cutaneous MCTs. Twenty-four dogs were included in the study; 13 animals were treated with IM and 11 with VP. Tumor tissue samples were submitted for histological diagnosis, grading and KIT immunostaining. The response to treatment was assessed by tomographic measurements according to VCOG criteria. Adverse events were classified according to VCOG-CTCAE criteria. The IM and VP groups had dogs with similar breeds, gender, ages, MCT localization, WHO stages and lymph node metastasis profiles. Most MCTs were grade 2/low and had KIT- patterns 2 and 3. The objective response rate (ORR) was significantly higher (30.79%) in the IM group then in VP group (9.09%). Adverse events (AE) in IM group were all grade 1, significantly different from VP. In conclusion, IM presented better ORR and less severe adverse events when compared to VP, representing a suitable option for the treatment of low-grade canine MCTs.

Comparison of two different vinblastine dosages for treatment of cutaneous mast cell tumor in dogs

Background: Mast cell tumors (MCT) are among the most common malignant cutaneous neoplasm in dogs with variable biologic behavior and remain a therapeutic challenge in high-grade cases. Surgery remains the primary treatment for canine MCT; however, chemotherapy and radiation therapy are commonly used to treat aggressive cases. The combination of vinblastine (VBL) at a dose of 2 mg/m² and prednisone is the classically described protocol for MCT treatment. Studies have shown the safety of higher VBL doses for dogs with MCT, but there is a lack of information regarding dose intensity and outcome as a goal after chemotherapy. This study aimed to evaluate the impact of a higher dose of VBL on MCT treatment outcome. Materials, Methods & Results: This was an observational and comparative study conducted in two different Veterinary Teaching Hospitals. Client-owned dogs with histopathological diagnosis of grade II or III MCT were selected and underwent at least four chemotherapy sessions with VBL and prednisone. The experimental group (EG) consisted of 18 dogs that received a dose of 3 mg/m² VBL treated in one institution. The control group (CG) included 31 dogs that received a dose of 2 mg/m² VBL treated at the other institution. All dogs treated in both groups had a clinical and complete blood count (CBC) evaluation performed previous the start of chemotherapy (T0) and before each weekly treatment (T1, T2, T3, and T4). After treatment, dogs in both groups were followed-up for the recurrence rate and overall survival time after diagnosis. There was no significant difference in clinical variables between EG and CG. During treatment, dogs of EG showed a significant reduction in erythrocyte, hemoglobin, and hematocrit values between T0 and T1, T2, T3, and T4 (P < 0.001). Comparatively, the CG showed significant reduction in hemoglobin (P = 0.02) and total leucocytes (P = 0.001) values in the same period. Despite these findings, these hematological...

Sporotrichosis outburst after cancer chemotherapy in a dog

Background: Sporotrichosis is a dermatozoonosis that affects mammals in general, with the domestic feline (Felis catus)being the most epidemiologically important species. However, diagnosis of this disease in dogs is important consideringthe proximity with people and with other communicants. The epidemiology of sporotrichosis is already known in somestates of Brazil, especially in the southeast region, but to the best of our knowledge there are no reports of sporotrichosisin non-human species in the state of Espírito Santo. This paper aimed at describing the first case of canine sporotrichosisin Espírito Santo, Brazil.Case: A 10 year-old Bull Terrier male dog was presented with nodular non-ulcerated lesions on the head and nodularulcerated lesion on the nasal planum. The dog had a previous diagnosis of a low-grade mast cell tumour and palpebralmelanoma. Mast cell tumour was treated with scrotum ablation (and orchiectomy) and bilateral inguinal lymph node removal, followed by chemotherapy with twelve intravenous infusion of vinblastine, along with prednisolone. Cutaneouslesions in the head and nasal planum appeared two months after finishing chemotherapy. At further anamnesis, the pet´sresponsible reported that the dog had the habit of hunting cats that entered the residence, which raised the hypothesis ofsporotrichosis. An undiagnostic cytology was performed, followed by a fungal culture, positive for Sporothrix schenckii.Treatment was then initiated with itraconazol (Oficial generic drug), at a dose of 10mg/kg/SID, until clinical remission,obtained after 60 days, maintaining it for 60 more days. Patient showed completed recovery, with no further complatintsafter a follow-up of more than 220 days.Discussion: Sporotrichosis is considered a rare disease in dogs, with isolated cases in the literature...(AU)

Sporotrichosis outburst after cancer chemotherapy in a dog

Background: Sporotrichosis is a dermatozoonosis that affects mammals in general, with the domestic feline (Felis catus)being the most epidemiologically important species. However, diagnosis of this disease in dogs is important consideringthe proximity with people and with other communicants. The epidemiology of sporotrichosis is already known in somestates of Brazil, especially in the southeast region, but to the best of our knowledge there are no reports of sporotrichosisin non-human species in the state of Espírito Santo. This paper aimed at describing the first case of canine sporotrichosisin Espírito Santo, Brazil.Case: A 10 year-old Bull Terrier male dog was presented with nodular non-ulcerated lesions on the head and nodularulcerated lesion on the nasal planum. The dog had a previous diagnosis of a low-grade mast cell tumour and palpebralmelanoma. Mast cell tumour was treated with scrotum ablation (and orchiectomy) and bilateral inguinal lymph node removal, followed by chemotherapy with twelve intravenous infusion of vinblastine, along with prednisolone. Cutaneouslesions in the head and nasal planum appeared two months after finishing chemotherapy. At further anamnesis, the pet´sresponsible reported that the dog had the habit of hunting cats that entered the residence, which raised the hypothesis ofsporotrichosis. An undiagnostic cytology was performed, followed by a fungal culture, positive for Sporothrix schenckii.Treatment was then initiated with itraconazol (Oficial generic drug), at a dose of 10mg/kg/SID, until clinical remission,obtained after 60 days, maintaining it for 60 more days. Patient showed completed recovery, with no further complatintsafter a follow-up of more than 220 days.Discussion: Sporotrichosis is considered a rare disease in dogs, with isolated cases in the literature...

Vinblastine and antihelmintic mebendazole potentiate temozolomide in resistant gliomas.

Glioblastoma (GBM) is a very aggressive tumor that has not had substantial therapeutic improvement since the introduction of temozolomide (TMZ) in combination with radiotherapy. Combining TMZ with other chemotherapeutic agents is a strategy that could be further explored for GBM. To search for molecular predictors of TMZ resistance, the TCGA (The Cancer Genome Atlas) database was utilized to assess the impact of specific genes on TMZ response. Patients whose tumors expressed low levels of FGFR3 and AKT2 responded poorly to TMZ. Combination treatment of vinblastine (VBL) plus mebendazole (MBZ) with TMZ was more effective in reducing cell number in most cultures when compared to TMZ alone, especially in cells with low expression levels of FGFR3 and AKT2. Cell cycle distribution and nuclear morphometric analysis indicated that the triple combination of TMZ, VBL and MBZ (TVM) was able to induce polyploidy and senescence, in addition to increasing the Notch3 RNA level in patient-derived gliomas. Thus, this set of data suggests that the triple combination of TMZ, VBL and MBZ may be a considerable therapeutic alternative for the TMZ-tolerant gliomas that harbor low expression of FGFR3/AKT2.

Yeast extract elicitation increases vinblastine and vincristine yield in protoplast derived tissues and plantlets in Catharanthus roseus

Abstract Catharanthus roseus (L.) G. Don, Apocynaceae, is an immensely important medicinal plant, produces a variety of anticancerous compounds. The yield of two most investigated alkaloids vinblastine and vincristine is unfortunately very low. A vast array of technologies including elicitation have recently been used to enrich Catharanthus alkaloid in culture. Yeast extract is a biotic elicitor, the polysaccharide and the peptide moiety have been recognized as a signalling element in enriching secondary metabolites. In this study, the yeast extract elicitation on vinblastine and vincristine was studied in various protoplast derived tissues and plantlets. Four different yeast extract treatments (T1 = 0.5 g/l, T2 = 1.0 g/l, T3 = 1.5 g/l and T4 = 2.0 g/l) were prepared and used. The alkaloid was quantified and a comparative account of yield were presented by the use of High performance thin layer chromatography. The yeast extract amendment in medium improved vinblastine and vincristine yield in cultivating tissues, maximum being in germinating embryos and in in vitro raised leaf. The highest yield was in T3 (1.5 mg/l) in which 22.74% vinblastine and 48.49% vincristine enrichment was noted in germinating embryos; the enhancement was however, treatment-specific. Antioxidant enzymes such as superoxide dismutase, catalase, ascorbate peroxidase and glutathione reductase activities were investigated as addition of yeast extract caused cellular stress and had enriched level of alkaloids.

Langerhans' cell histiocytosis diagnosed due to dermatological perianal lesion / Histiocitose de células de Langerhans diagnosticada por lesão perianal dermatológica

Abstract Langerhans' cell histiocytosis is a rare disease characterized by proliferation of Langerhans cells in the body. It affects mainly males, predominantly in childhood. Ulcerated plaques are one of the cutaneous forms of presentation. Diagnostic confirmation is done through immunohistochemistry. As therapeutic options, topical corticosteroids and chemotherapy are good choices. The case is reported of a male patient, aged 14, with perianal ulceration. He consulted a coloproctologist, who performed a biopsy of the region and started local triamcinolone applications. Immunohistochemistry diagnosed Langerhans' cells histiocytosis. Further investigation revealed diabetes insipidus, osteolytic lesions in the skull and lower limbs, enlarged liver, and encephalic alterations. Chemotherapy was started with Vinblastine, with significant improvement of the lesions.

Resumo A histiocitose de células de Langerhans é uma doença rara caracterizada pela proliferação de células de Langerhans no corpo. A doença afeta principalmente os homens, predominantemente na infância. Placas ulceradas são uma das formas cutâneas de apresentação. A confirmação diagnóstica é feita através de análise imuno-histoquímica. Como opções terapêuticas, corticosteroides tópicos e quimioterapia são boas escolhas. O caso aqui relatado é de um paciente do sexo masculino, com idade de 14 anos, com ulceração perianal. Ele consultou um coloproctologista, que realizou uma biópsia da região e iniciou o tratamento com aplicações locais de triancinolona. A análise imunohistoquímica diagnosticou histiocitose de células de Langerhans. Outros exames revelaram diabetes insipidus, lesões osteolíticas no crânio e nos membros inferiores, aumento do fígado e alterações encefálicas. A quimioterapia foi iniciada com vimblastina, com melhora significativa das lesões.

Linfoma Hodgkin clássico de apresentação incomum. Relato de caso / An unusual presentation of a classic Hodgkin lymphoma. Case report

O linfoma é uma neoplasia originária do sistema linfático, a partir de células linfocitárias. A sintomatologia mais comum é febre, tosse, sudorese noturna, perda de peso, fraqueza e linfoadenopatia indolor. A etiologia ainda permanece desconhecida, tendo sido relacionada ao vírus Epstein-Barr. O diagnóstico se baseia na visualização das células de Reed-Sternberg. O esquema adriamicina, bleomicina, vinblastina e dacarbazina (ABVD) ainda é o tratamento preconizado, associado ou não à radioterapia. Relatamos um caso de linfoma de Hodgkin de apresentação atípica, cujo diagnóstico só foi possível por esplenectomia.(AU)

The lymphoma is a cancer of the lymphatic system originating from lymphocyte cells. The most common symptoms are fever, cough, night sweats, weight loss, weakness, and painless lymphadenopathy. The etiology remains unknown, having been related to the Epstein Barr virus. The diagnosis is based on visualization of Reed Sternberg cells. The adriamycin, bleomicin, vinblastine and dacarbazine (ABVD) regimen is still the preferred treatment, with or without radiation therapy. We report a case of Hodgkin's lymphoma of atypical presentation, the diagnosis of which was only possible through splenectomy.(AU)

Severe hypokalemia due to a possible drug-drug interaction between vinblastine and antiretrovirals in a HIV-infected patient with Hodgkin's lymphoma.

A 60-year-old HIV-1 infected woman on antiretroviral therapy (emtricitabine/tenofovir, and ritonavir-boosted atazanavir) developed Hodgkin's lymphoma. The patient initiated ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) chemotherapy and presented with neutropenia and severe hypokalemia. Hypokalemia was considered as part of a proximal tubular renal dysfunction, and other causes of hypokalemia were excluded. Due to suspicion of drug--drug interactions between antiretrovirals and vinblastine, ritonavir-boosted atazanavir was switched to dolutegravir and the patient continued emtricitabine/tenofovir. In the subsequent ABVD cycles, no neutropenia or hypokalemia were observed. Vinblastine is metabolized by the hepatic P450 cytochrome isoenzyme CYP3A4, therefore, concomitant administration with protease inhibitors may increase plasma levels of vinblastine. Vinblastine is also a substrate and inhibitor of multidrug resistance-associated protein 2 (MRP2) transporter in the proximal renal tubule. Inhibition of this renal transporter could increase tenofovir renal toxicity. Our hypothesis is that the hypokalemia could be a result of a tenofovir-mediated tubular damage triggered by the increased vinblastine serum levels secondary to a CYP3A4 inhibition by ritonavir. To the best of our knowledge, this is the first report of severe hypokalemia and proximal tubular renal dysfunction as a result of a possible drug-drug interaction between vinblastine, tenofovir and ritonavir-boosted atazanavir.

Leishmania amazonensis: Increase in ecto-ATPase activity and parasite burden of vinblastine-resistant protozoa.

Leishmania amazonensis is a protozoan parasite that induces mucocutaneous and diffuse cutaneous lesions upon infection. An important component in treatment failure is the emergence of drug-resistant parasites. It is necessary to clarify the mechanism of resistance that occurs in these parasites to develop effective drugs for leishmaniasis treatment. Promastigote forms of L. amazonensis were selected by gradually increasing concentrations of vinblastine and were maintained under continuous drug pressure (resistant cells). Vinblastine-resistant L. amazonensis proliferated similarly to control parasites. However, resistant cells showed changes in the cell shape, irregular flagella and a decrease in rhodamine 123 accumulation, which are factors associated with the development of resistance, suggesting the MDR phenotype. The Mg-dependent-ecto-ATPase, an enzyme located on cell surface of Leishmania parasites, is involved in the acquisition of purine and participates in the adhesion and infectivity process. We compared control and resistant L. amazonensis ecto-enzymatic activities. The control and resistant Leishmania ecto-ATPase activities were 16.0 ± 1.5 nmol Pi × h(-1) × 10(-7) cells and 40.0 ± 4.4 nmol Pi × h(-1) × 10(-7)cells, respectively. Interestingly, the activity of other ecto-enzymes present on the L. amazonensis cell surface, the ecto-5' and 3'-nucleotidases and ecto-phosphatase, did not increase. The level of ecto-ATPase modulation is related to the degree of resistance of the cell. Cells resistant to 10 µM and 60 µM of vinblastine have ecto-ATPase activities of 22.7 ± 0.4 nmol Pi × h(-1) × 10(-7) cells and 33.8 ± 0.8 nmol Pi × h(-1) × 10(-7)cells, respectively. In vivo experiments showed that both lesion size and parasite burden in mice infected with resistant parasites are greater than those of L. amazonensis control cells. Furthermore, our data established a relationship between the increase in ecto-ATPase activity and greater infectivity and severity of the disease caused by vinblastine-resistant L. amazonensis promastigotes. Taken together, these data suggest that ecto-enzymes could be potential therapeutic targets in the struggle against the spread of leishmaniasis, a neglected world-wide public health problem.

Autologous hematopoietic stem cell transplantation in classical Hodgkin's lymphoma

BACKGROUND: Hodgkin's lymphoma has high rates of cure, but in 15 percent to 20 percent of general patients and between 35 percent and 40 percent of those in advanced stages, the disease will progress or will relapse after initial treatment. For this group, hematopoietic stem cell transplantation is considered one option of salvage therapy. OBJECTIVES: To evaluate a group of 106 patients with Hodgkin's lymphoma, who suffered relapse or who were refractory to treatment, submitted to autologous hematopoietic stem cell transplantation in a single transplant center. METHODS: A retrospective study was performed with data collected from patient charts. The analysis involved 106 classical Hodgkin's lymphoma patients who were consecutively submitted to high-dose chemotherapy followed by autologous transplants in a single institution from April 1993 to December 2006. RESULTS: The overall survival rates of this population at five and ten years were 86 percent and 70 percent, respectively. The disease-free survival was approximately 60 percent at five years. Four patients died of procedure-related causes but relapse of classical Hodgkin's lymphoma after transplant was the most frequent cause of death. Univariate analysis shows that sensitivity to pre-transplant treatment and hemoglobin < 10 g/dL at diagnosis had an impact on patient survival. Unlike other studies, B-type symptoms did not seem to affect overall survival. Lactic dehydrogenase and serum albumin concentrations analyzed at diagnosis did not influence patient survival either. CONCLUSION: Autologous hematopoietic stem cell transplantation is an effective treatment strategy for early and late relapse in classical Hodgkin's lymphoma for cases that were responsive to pre-transplant chemotherapy. Refractory to treatment is a sign of worse prognosis. Additionally, a hemoglobin concentration below 10 g/dL at diagnosis of Hodgkin's lymphoma has a negative impact on the survival of patients after transplant. As far as we know this relationship has not been previously reported.

Autologous hematopoietic stem cell transplantation in classical Hodgkin's lymphoma.

BACKGROUND: Hodgkin's lymphoma has high rates of cure, but in 15% to 20% of general patients and between 35% and 40% of those in advanced stages, the disease will progress or will relapse after initial treatment. For this group, hematopoietic stem cell transplantation is considered one option of salvage therapy. OBJECTIVES: To evaluate a group of 106 patients with Hodgkin's lymphoma, who suffered relapse or who were refractory to treatment, submitted to autologous hematopoietic stem cell transplantation in a single transplant center. METHODS: A retrospective study was performed with data collected from patient charts. The analysis involved 106 classical Hodgkin's lymphoma patients who were consecutively submitted to high-dose chemotherapy followed by autologous transplants in a single institution from April 1993 to December 2006. RESULTS: The overall survival rates of this population at five and ten years were 86% and 70%, respectively. The disease-free survival was approximately 60% at five years. Four patients died of procedure-related causes but relapse of classical Hodgkin's lymphoma after transplant was the most frequent cause of death. Univariate analysis shows that sensitivity to pre-transplant treatment and hemoglobin < 10 g/dL at diagnosis had an impact on patient survival. Unlike other studies, B-type symptoms did not seem to affect overall survival. Lactic dehydrogenase and serum albumin concentrations analyzed at diagnosis did not influence patient survival either. CONCLUSION: Autologous hematopoietic stem cell transplantation is an effective treatment strategy for early and late relapse in classical Hodgkin's lymphoma for cases that were responsive to pre-transplant chemotherapy. Refractory to treatment is a sign of worse prognosis. Additionally, a hemoglobin concentration below 10 g/dL at diagnosis of Hodgkin's lymphoma has a negative impact on the survival of patients after transplant. As far as we know this relationship has not been previously reported.

Tratamento de tumor venéreo transmissível extragenital resistente à vincristina: quimioterapia antineoplásica e cirurgia reconstrutiva / Treatment of transmissible venereal extragenital tumor vincristine resistant: antineoplastic chemotherapy and reconstructive surgery

O Tumor Venéreo Transmissível (TVT) é uma neoplasia transmitida por células transplantáveis, com localização predominantemente venérea, podendo ainda ser encontrado em regiões extragenitais. Os agentes quimioterápicos são a opção mais utilizada no tratamento do TVT, sendo o sulfato de vincristina a droga de eleição e o sulfato de vimblastina uma alternativa de tratamento. O objetivo deste trabalho é relatar o tratamento de um caso de TVT nasal sem comprometimento genital, com destruição de tecidos moles e perda óssea, resistente à vincristina. Foi instituído inicialmente tratamento quimioterápico com sulfato de vincristina e posterior substituição por sulfato de vimblastina. Com a evolução do tratamento, houve regressão do tecido neoplásico e surgiram fístulas no local antes ocupado pelo tumor. Assim, quando já se havia obtido cura clínica e citologia negativa para células tumorais, realizou-se cirurgia reconstrutiva no palato e na maxila. Até o 180° dia de observação,o cão encontrava-se bem, com deformidade óssea na face mas sem alterações funcionais. Esse relato demonstra que o uso do sulfato de vimblastina foi um protocolo eficaz para o tratamento de TVT delocalização extragenital e que a utilização da quimioterapia antineoplásica seguida por cirurgia reconstrutiva é efetiva,capaz de proporcionar cura e qualidade de vida ao paciente

The transmissible venereal tumor (TVT) is a neoplasm transmitted by transplantable cells, with predominant venereal location, but also found in extragenital regions. Antineoplasic chemotherapy is the most used treatment for TVT. The vincristine sulphate is the drug of choice and vinblastine sulphate, an alternative chemotherapeutic agent. This work aims to report a case of nasal TVT without compromised genital areas, destroying tissue and bone loss, resistant to vincristine. Chemotherapic treatment with vincristine sulphate was initially established and subsequently replaced by vinblastine sulphate. After treatment, there was regression of the tumor and fistulas appeared on the areas previously occupied by the tumor. When clinical cure and negative cytology for tumor cells were achieved, reconstructive surgery was proceded on the palate and jaw. After 180 days of observation, the dog was healthy, presenting bone deformity in the face but without functional changes. This report demonstrates that vinblastine sulphate was an effective protocol for the treatment of extragenital TVT and that the use of anticancer chemotherapy followed by reconstructive surgery is effective, capable of inducing healing and quality of life for patients

Tratamento de tumor venéreo transmissível extragenital resistente à vincristina: quimioterapia antineoplásica e cirurgia reconstrutiva / Treatment of transmissible venereal extragenital tumor vincristine resistant: antineoplastic chemotherapy and reconstructive surgery

O Tumor Venéreo Transmissível (TVT) é uma neoplasia transmitida por células transplantáveis, com localização predominantemente venérea, podendo ainda ser encontrado em regiões extragenitais. Os agentes quimioterápicos são a opção mais utilizada no tratamento do TVT, sendo o sulfato de vincristina a droga de eleição e o sulfato de vimblastina uma alternativa de tratamento. O objetivo deste trabalho é relatar o tratamento de um caso de TVT nasal sem comprometimento genital, com destruição de tecidos moles e perda óssea, resistente à vincristina. Foi instituído inicialmente tratamento quimioterápico com sulfato de vincristina e posterior substituição por sulfato de vimblastina. Com a evolução do tratamento, houve regressão do tecido neoplásico e surgiram fístulas no local antes ocupado pelo tumor. Assim, quando já se havia obtido cura clínica e citologia negativa para células tumorais, realizou-se cirurgia reconstrutiva no palato e na maxila. Até o 180° dia de observação,o cão encontrava-se bem, com deformidade óssea na face mas sem alterações funcionais. Esse relato demonstra que o uso do sulfato de vimblastina foi um protocolo eficaz para o tratamento de TVT delocalização extragenital e que a utilização da quimioterapia antineoplásica seguida por cirurgia reconstrutiva é efetiva,capaz de proporcionar cura e qualidade de vida ao paciente(AU)

The transmissible venereal tumor (TVT) is a neoplasm transmitted by transplantable cells, with predominant venereal location, but also found in extragenital regions. Antineoplasic chemotherapy is the most used treatment for TVT. The vincristine sulphate is the drug of choice and vinblastine sulphate, an alternative chemotherapeutic agent. This work aims to report a case of nasal TVT without compromised genital areas, destroying tissue and bone loss, resistant to vincristine. Chemotherapic treatment with vincristine sulphate was initially established and subsequently replaced by vinblastine sulphate. After treatment, there was regression of the tumor and fistulas appeared on the areas previously occupied by the tumor. When clinical cure and negative cytology for tumor cells were achieved, reconstructive surgery was proceded on the palate and jaw. After 180 days of observation, the dog was healthy, presenting bone deformity in the face but without functional changes. This report demonstrates that vinblastine sulphate was an effective protocol for the treatment of extragenital TVT and that the use of anticancer chemotherapy followed by reconstructive surgery is effective, capable of inducing healing and quality of life for patients(AU)

Histiocitose de células de Langerhans: doença de Letterer-Siwe - importância do diagnóstico dermatológico em dois casos / Langerhans cell histiocytosis: Letterer-Siwe disease - the importance of dermatological diagnosis in two cases

A histiocitose de células de Langerhans é proliferação clonal de células fenotipicamente semelhantes às células de Langerhans. Anteriormente denominada Letterer-Siwe, é a forma mais comum e mais grave dessa enfermidade, acometendo sobretudo crianças até os dois anos de idade. São apresentados dois casos dessa rara doença, diagnosticados após parecer dermatológico, destacando-se seus aspectos mais característicos.

Langerhans cell histiocytosis is defined as a clonal proliferation of Langerhans phenotypic-like cells. Letterer-Siwe disease is the most common and serious of these entities, affecting mainly infants up to two years of age. We present two cases of this rare disease, diagnosed after dermatological examination, highligthing its typical aspects.