Long-term Treatment of Chronic Lymphocytic Leukemia in a Green-winged Macaw (Ara chloroptera)

• Published in: Journal of avian medicine and surgery Vol. 24; no. 4; pp. 330 - 338
• Main Authors: Hammond, Elizabeth E, Guzman, David Sanchez-Migallon, Garner, Michael M, Mauldin, Glenna, Martinez-Jimenez, David, Kiupel, Matti, Aguilar, Roberto F
• Format: Journal Article
• Language: English
• Published: P.O. Box 210732, Bedford, TX 76095, USA Association of Avian Veterinarians 01-12-2010
• Subjects: Animals; Antibodies; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - therapeutic use; Ara chloroptera; avian; Bird Diseases - drug therapy; Birds; Blood; Bone marrow; Cancer; Care and treatment; Causes of; Chemotherapy; Chlorambucil; Chronic lymphocytic leukemia; CLINICAL REPORTS; Cyclophosphamide; Dosage and administration; Drug Administration Schedule; Drug therapy; green-winged macaw; Health aspects; Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy; Leukemia, Lymphocytic, Chronic, B-Cell - veterinary; Leukocytes; Leukocytosis; Lymphocytes; Macaws; Male; Neoplasia; Parrots; Prednisone; T cell; thrombocytopenia; United States
• ISSN: 1082-6742; 1938-2871
• DOI: 10.1647/2009-001.1

A 32-year-old green-winged macaw (Ara chloroptera) was diagnosed with chronic lymphocytic leukemia based on progressive lymphocytosis and the presence of a monomorphic population of well-differentiated lymphocytes in the bone marrow of a clinically normal bird. Chemotherapy was initiated because of rapidly increasing peripheral lymphocyte counts. In addition to oral prednisone (1 mg/kg once daily), oral chlorambucil (1 mg/kg twice weekly) was initiated but was discontinued after 6 weeks because of thrombocytopenia. The leukocyte count was stabilized for 29 weeks with the concurrent use of oral cyclophosphamide (5 mg/kg 4 d/wk) and daily prednisone, and the bird exhibited a good quality of life. The bird died shortly after the chemotherapy was inadvertently discontinued. The neoplastic cells from this macaw stained positive for CD-3 antibody and negative for Bla.36, suggesting the leukemia was of T-cell origin. This is the first report of long-term treatment of a macaw with cyclophosphamide and documents thrombocytopenia in a macaw secondary to chlorambucil treatment.