PMC6196918_01
(a) A dog with an inoperable oral SCC and a metastatic lymph node before the study (lymph node staged via FNA and cytology, node not visible in image (a). (b) 3 weeks after the second HylaPlat injection. (c) After 4 HylaPlat injections, lymph node became cancer free and tumor downstaged to resectable and removed (lymph node staged via FNA and cytology, node not visible in image (c).
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Terrier was presented for evaluation of a large and fast-growing mass on the front of lower jaw, involving several teeth (Figure 1). The dog was rescued from a pound by an animal rescue shelter about 3 weeks prior to evaluation. BUN nor creatinine was elevated during the treatment period. Both values were within normal limits (Supplemental Figure 1). The dog was present 4 weeks after the surgery and a physical exam indicated that the healing of the surgical site was satisfactory (Figure 1).
Values of liver enzymes over time. Clinical chemistry indicated that liver enzymes (AST, ALT, and ALP) were within normal limits during the entire study except on day 58 when AST and ALT were temporarily elevated and over the upper limit (AST was 157 IU/L with a REF range of 15-66 IU/L; ALT was 161 IU/L with a REF range of 12-118 IU/L). All three liver enzymes returned to normal range by day 68.
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ALT, and ALP) were within normal limits during the entire study except on day 58 when AST and ALT were temporarily elevated and over the upper limit (AST was 157 IU/L with a REF range of 15-66 IU/L; ALT was 161 IU/L with a REF range of 12-118 IU/L). All three liver enzymes returned to normal range by day 68 (Figure 2).
Neutrophil counts before and after chemotherapy treatments. The pretreatment result included 4 data points, each of which was generated using a sample collected before each treatment. The posttreatment result also included 4 data points, each of which was generated using a sample collected after each treatment. Result indicated that neutrophil counts at pre- and posttreatments were not statistically different (p>0.05, AVONA, GraphPad Prism).
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Results indicated that neutrophil counts at pre- and posttreatments were not statistically different (p>0.05, AVONA, GraphPad Prism), suggesting that HylaPlat chemotherapy did not result in bone marrow suppression for this patient (Figure 3).
Hematocrit before and after chemotherapy treatments. The pretreatment result included 4 data points, each of which was generated using a sample collected before each treatment. The posttreatment result also included 4 data points, each of which was generated using a sample collected after each treatment. Result indicated that hematocrit did not alter significantly between pre- and posttreatments (p>0.05, AVONA, GraphPad Prism).
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Similarly, hematocrit did not alter significantly between pre- and posttreatments (p>0.05, AVONA, GraphPad Prism), indicating that HylaPlat chemotherapy did not significantly compromise hematopoiesis (Figure 4).
Platelet counts over time. Temporary thrombocytopenia was reported from day 4 to 8 after the third treatment. The effect was transient and the patient's low platelets resolved without medical intervention on day 12 after the third treatment.
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Temporary thrombocytopenia was reported from day 4 to 8 after the third treatment (Figure 5).
Sagittal views of computed tomography (CT) were obtained before study (a) and one month after the last treatment (b). Tumor shrinkage was observed.
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Chest radiographs suggested no evidence of metastasis to the lungs. CT of the head demonstrated that the margins of the mass had regressed compared to the CT prior to the chemotherapy and were no longer invading the lingual frenulum (Figure 6).