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INAZUMI H, TOYODA H, SHIMANO S, SAKUMA H, SAKAMOTO M, NAKAGAWA T, FUKUOKA R, OHMI A, CHAMBERS JK, UCHIDA K, GOTO-KOSHINO Y, TOMIYASU H. Efficacy and adverse events of L-Asparaginase administration as a first-line treatment for feline large-cell gastrointestinal lymphoma. J Vet Med Sci 2024; 86:727-736. [PMID: 38825481 PMCID: PMC11251808 DOI: 10.1292/jvms.23-0453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/21/2024] [Indexed: 06/04/2024] Open
Abstract
L-Asparaginase (L-Asp) is often used to induce remission in feline large-cell gastrointestinal lymphoma (LCGIL). However, no study has evaluated the efficacy and adverse events following the initial use of this drug as a first-line treatment in feline LCGIL. We retrospectively reviewed medical records of cats with LCGIL treated with L-Asp to induce remission. This study included 43 cats. The response rate (RR) after the first administration of L-Asp was 37.2% (Complete remission: 7.0%, partial remission: 30.2%). RR was significantly higher in cases with primary gastric lesions (64.3%) than in those with primary intestinal lesions (24.1%) (P=0.018), and it was also higher in cases without anemia (57.1%) than those with anemia (15.0%) (P=0.009). The most common adverse event was hyperammonemia, which occurred in 10 of 12 cases where we could compare plasma ammonia concentrations before and after the first dose of L-Asp. Plasma phosphate concentrations were also significantly increased (P<0.001) within 24 hr after the first dose. Decreased appetite, vomiting, and diarrhea were also observed in five, three, and seven cases, respectively, and Grade 3 or higher gastrointestinal signs were observed as adverse events in three cases. The median overall survival of all cats was 150 days (range, 5-1,065 days), and the median progression-free survival was 104 days (range, 2-978 days). In conclusion, L-Asp was effective to induce remission, and severe adverse events were uncommon in feline LCGIL.
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Affiliation(s)
- Haruka INAZUMI
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
| | - Hiroto TOYODA
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
| | - Shotaro SHIMANO
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
| | - Hiroki SAKUMA
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
| | - Megumi SAKAMOTO
- Veterinary Medical Center, Graduate School of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
| | - Taisuke NAKAGAWA
- Veterinary Medical Center, Graduate School of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
| | - Ray FUKUOKA
- Veterinary Medical Center, Graduate School of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
| | - Aki OHMI
- Veterinary Medical Center, Graduate School of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
| | - James K CHAMBERS
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Kazuyuki UCHIDA
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Yuko GOTO-KOSHINO
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
| | - Hirotaka TOMIYASU
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Sciences, The University of Tokyo, Tokyo, Japan
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Blaxill JE, Bennett PF. Evaluation of clinical response and prognostic factors in canine multicentric lymphoma treated with first rescue therapy. Vet Comp Oncol 2024; 22:265-277. [PMID: 38646859 DOI: 10.1111/vco.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 04/23/2024]
Abstract
Despite an initial strong response in most dogs with multicentric lymphoma treated with chemotherapy, relapse remains common. There is no clearly superior first rescue protocol described either for resistant or relapsed canine multicentric lymphoma. The objectives of this study were to assess clinical response and outcomes for canine multicentric lymphoma treated with first rescue protocols. The secondary objective was to assess prognostic variables for dogs undergoing these protocols. This was a bi-institutional retrospective cohort study. Two hundred and sixty-five dogs were treated with first rescue chemotherapy, including anthracycline-based combination chemotherapy (CHOP-like, n = 50), nitrosourea alkylating agent-rich chemotherapy (n = 45), anthracycline-based or related compound chemotherapy (n = 34), or nitrosourea single-agent chemotherapy (n = 136). The overall median progression free survival time of first rescue protocol was 56.0 days (0-455 days). Important prognostic factors identified for first rescue protocol included the attainment of a complete response to the first rescue chemotherapy (p < .001), the use of a CHOP-like first rescue protocol (p = .009), duration of first remission (HR 0.997, p = .028), and if prednisolone was included in the first rescue protocol (HR 0.41, p = .003). Adverse events (AE) were common, with 81.1% of dogs experiencing at least one AE during first rescue chemotherapy. This study highlights the need for improved first rescue therapies to provide durable remission in canine resistant or relapsed lymphoma.
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Affiliation(s)
- John E Blaxill
- Small Animal Specialist Hospital, North Ryde, New South Wales, Australia
| | - Peter F Bennett
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Victoria, Australia
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Bennett P, Williamson P, Taylor R. Review of Canine Lymphoma Treated with Chemotherapy-Outcomes and Prognostic Factors. Vet Sci 2023; 10:vetsci10050342. [PMID: 37235425 DOI: 10.3390/vetsci10050342] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
While canine lymphoma is a relatively common and important disease seen by veterinarians, there are limited comprehensive reviews of the literature regarding the remission and survival times following chemotherapy, and the associated prognostic factors. This comprehensive thematic review covers the available veterinary literature covering treatment outcomes and identified prognostic factors. A lack of standardised approaches to evaluate and report the outcomes was identified, including factors that would alter the duration of responses by weeks, or occasionally months. After publication of the suggested reporting criteria, this has improved but is still not uniformly applied. The prognostic factors included for evaluation varied from as few as three to seventeen, with over 50 studies using only univariate analysis. Individual papers reported much longer outcomes than others, but assessing the outcomes overall, there has been minimal change over the last 40 years. This supports the belief that novel approaches for lymphoma therapy will be required to substantively improve outcomes.
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Affiliation(s)
- Peter Bennett
- The Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown, NSW 2006, Australia
- The University of Sydney Nano Institute, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Peter Williamson
- The Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Rosanne Taylor
- The Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown, NSW 2006, Australia
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Musser ML, Clifford CA, Bergman PJ, Treml LS, McAnulty LCC, McNiel EA, Johannes CM. Randomised trial evaluating chemotherapy alone or chemotherapy and a novel monoclonal antibody for canine T-cell lymphoma: A multicentre US study. Vet Rec Open 2022; 9:e49. [PMID: 36329876 PMCID: PMC9624070 DOI: 10.1002/vro2.49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/15/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
Background Canine peripheral nodal T-cell lymphoma is considered chemotherapy resistant and carries a relatively poor prognosis. Prospective evaluations reporting the impact of chemotherapy on progression-free survival (PFS) and overall survival time for dogs with T-cell lymphoma are lacking. This study examined the impact of L-CHOP (L-asparaginase, doxorubicin, cyclophosphamide, vincristine, prednisone) chemotherapy or L-CHOP in combination with AT-005, a US Department of Agriculture-licensed caninised monoclonal antibody, on PFS and response rates in dogs with clinical intermediate- and high-grade peripheral nodal T-cell lymphoma. Methods A prospective, randomised, placebo-controlled, investigator- and owner-blinded, multicentre study was completed. All dogs received a 19-week L-CHOP chemotherapy protocol with randomisation (1:1) into placebo or AT-005 groups. Response was evaluated via the Veterinary Cooperative Oncology Group criteria for canine lymphoma. Results Forty-nine dogs were enrolled (25 received placebo and 24 received AT-005). Most demographic factors were similar between the two groups, with the exception that more dogs with stage IV and V disease were treated with AT-005 (34% vs. 8%; p = 0.03). Median PFS was 103 days (95% confidence interval [CI], 56-118) in the placebo group versus 64 days (95% CI, 36-118) in the AT-005 group. The overall response rate (ORR) for all dogs was 98% (48 of 49); complete response rate in the placebo group (64%) was not different from the AT-005 group (67%). Conclusions To the best of the authors' knowledge, this is the first prospective study to document that treatment with L-CHOP chemotherapy, with or without AT-005, may result in a high ORR, but relatively brief PFS in dogs with clinical intermediate- and high-grade T-cell lymphoma.
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Affiliation(s)
- Margaret L. Musser
- Iowa State University College of Veterinary MedicineLloyd Veterinary Medical CenterAmesIowaUSA
| | - Craig A. Clifford
- Blue Pearl Malvern/Hope Veterinary SpecialistsMalvernPennsylvaniaUSA
| | - Philip J. Bergman
- Department of Clinical StudiesVCA, Katonah Bedford Veterinary CenterBedford HillsNew YorkUSA
| | | | | | | | - Chad M. Johannes
- Colorado State University College of Veterinary Medicine and Biomedical Sciences, Flint Animal Cancer CenterFort CollinsCOUSA
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O'Connell K, Thomson M, Morgan E, Henning J. Procarbazine, prednisolone and cyclophosphamide (PPC) oral combination chemotherapy protocol for canine lymphoma. Vet Comp Oncol 2022; 20:613-622. [PMID: 35338560 DOI: 10.1111/vco.12814] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/02/2022] [Accepted: 03/22/2022] [Indexed: 11/29/2022]
Abstract
Orally administered daily chemotherapy offers a novel treatment approach for canine lymphoma in a population of dogs that have failed or not tolerated maximum tolerable dose chemotherapy. A multidrug oral chemotherapy protocol was designed and implemented for the treatment of fifty dogs with multicentric lymphoma with minimal side effects. The protocol consisted of oral procarbazine, prednisolone and cyclophosphamide (PPC) administered daily. Efficacy and toxicity were evaluated by clinical and laboratory evaluation. An overall response rate of 70% was achieved, with 24% and 46% of dogs having a partial and complete response, respectively, to treatment with the PPC protocol. Response to the PPC protocol (complete or partial) and age were the only factors identified as prognostic for time from initiation of the PPC chemotherapy until death. Overall, the protocol was very well tolerated with only one dog requiring protocol discontinuation due to grade 4 thrombocytopenia. Eight dogs recorded gastrointestinal toxicities, seven grade I and one grade II toxicity. These findings demonstrate that the administration of a continuous oral combination chemotherapy can provide comparable survival times in the rescue setting in dogs with multicentric lymphoma with minimal side effects.
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Affiliation(s)
- Kathleen O'Connell
- Animal Referral Hospital Brisbane, 532 Seventeen Mile Rocks Road, Sinnamon Park QLD 4073
| | - Maurine Thomson
- Animal Referral Hospital Brisbane, 532 Seventeen Mile Rocks Road, Sinnamon Park QLD 4073
| | - Elizabeth Morgan
- Animal Referral Hospital Brisbane, 532 Seventeen Mile Rocks Road, Sinnamon Park QLD 4073
| | - Joerg Henning
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
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Treggiari E, Cossu G, Valenti P, Taylor A. Risk factors associated with the onset of lomustine‐induced neutropenia in tumour‐bearing dogs. Vet Comp Oncol 2022; 20:577-586. [PMID: 35249267 DOI: 10.1111/vco.12809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 12/01/2022]
Affiliation(s)
| | - G. Cossu
- Willows Veterinary Centre and Referral Service Solihull West Midlands UK
| | - P. Valenti
- Clinica Veterinaria Malpensa, Samarate Varese Italy
| | - A. Taylor
- Royal Veterinary College Queen Mother Hospital for Animals Hatfield UK
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Blaxill J, Buzzacott P, Finlay J. Prognostic indicators for naïve canine non-indolent T-cell lymphoma treated with combination lomustine, vincristine, procarbazine and prednisolone chemotherapy. Vet Comp Oncol 2021; 20:215-226. [PMID: 34464024 DOI: 10.1111/vco.12768] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022]
Abstract
Lomustine, vincristine, procarbazine and prednisolone (LOPP) chemotherapy has been suggested to be an effective treatment for dogs with naïve non-indolent T-cell lymphoma (TCL). Studies evaluating prognostic factors for dogs with TCL treated with LOPP chemotherapy are lacking. The aim of this retrospective study was to assess potential prognostic factors for canine naïve non-indolent TCL treated with the LOPP protocol. This was a retrospective cohort study of naïve non-indolent TCL treated with the LOPP chemotherapy protocol at a single specialty veterinary oncology clinic. Sixty-seven dogs met the inclusion criteria. The outcomes assessed included progression free survival (PFS), overall survival time (OST) and duration of complete response (DCR). The overall median PFS was 118 days (range 7-2302 days). The median OST was 202 days (range 8-2302 days). The overall median DCR was 316 days (range 38-2261 days). Number of treatments administered (p < .0001), multicentric disease (p = .044) and the presence of hypercalcaemia (p = .006) were prognostic indicators for PFS. Increasing number of treatments (p < .0001) and age (p = .0088) were prognostic indicators for OST. To our knowledge, this is the first study to describe hypercalcaemia as a positive prognostic indicator of PFS for TCL treated with LOPP chemotherapy. LOPP chemotherapy can be considered as a first-line treatment protocol against naïve hypercalcaemic non-indolent TCL.
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Affiliation(s)
- John Blaxill
- University of Sydney Veterinary Teaching Hospital, Sydney, New South Wales, Australia
| | - Peter Buzzacott
- School of Nursing, Curtin University, Bentley, Western Australia, Australia
| | - Jessica Finlay
- Perth Veterinary Specialists, Osborne Park, Western Australia, Australia
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Troedson K, Ignatenko N, Fejos C, Zablotski Y, Hirschberger J. Maintenance treatment in relapsed canine lymphoma after a short L-CHOP protocol. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2021; 49:185-194. [PMID: 34157760 DOI: 10.1055/a-1481-7066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE A number of different rescue protocols for relapsed canine multicentric large-cell lymphoma have been described. The aim of this pilot study was to evaluate the efficacy of a maintenance treatment in dogs that experienced a second complete remission after a short L-CHOP-rescue protocol. MATERIAL AND METHODS Included in the study were dogs experiencing the first lymphoma relapse during a treatment-free period which were treated with a short L-CHOP protocol, achieved a complete remission and were afterwards treated with a continuous maintenance phase (MP) protocol. The L-CHOP protocol consisted of weekly treatments, with at least 3 additional treatments following complete remission. Thereafter the MP protocol with 2-week treatment intervals was conducted. It consisted of alternating oral home administration of different alkylating agents and one intravenously administered cytotoxic agent of a different mechanism of action. The dogs were presented either every 4 or 6 weeks for intravenous treatment and at this time a complete blood count was performed. The durations of the first remission, disease-free interval and overall survival time were evaluated. RESULTS A total of 20 dogs were included in the study. A median of 7 weekly applications were given before the treatment was switched to the MP protocol. During MP, 14 dogs were treated intravenously every 6 weeks and 6 dogs every 4 weeks. Haematological adverse events were mainly mild. During the L-CHOP-protocol, one septic event occurred, and 2 dogs were hospitalized due to gastrointestinal adverse events. No patient required hospitalization during the MP. Fifteen dogs completed at least one cycle in the MP and a median of 8.5 chemotherapeutic treatments were administered. The median disease-free interval was 264 days and the median overall survival time was 737 days. CONCLUSION AND CLINICAL RELEVANCE The protocol was generally well tolerated. Since 5 patients showed disease progression during the first cycle of the MP, dogs should ideally be evaluated for minimal residual disease before being switched to the MP. The case number in the presented study was low and the treatment relatively heterogeneous. Therefore, more dogs have to be treated with the proposed protocol before general recommendations can be made.
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Affiliation(s)
- Karin Troedson
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, LMU Munich
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Klimiuk P, Łopuszyński W, Bulak K, Brzana A. Evaluation of the Proliferative Activity of Diffuse Large B-Cell Lymphoma (DLBCL) in Dogs with Respect to Patient Eligibility for Anthracycline-Based Chemotherapy. Animals (Basel) 2021; 11:ani11041183. [PMID: 33924252 PMCID: PMC8074745 DOI: 10.3390/ani11041183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/12/2021] [Accepted: 04/17/2021] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Canine lymphomas usually have aggressive behavior, but respond well to chemotherapy. Despite proper diagnosis and numerous available therapeutic regimens, it is difficult to determine the prognosis and choose the optimal method of treatment in each individual patient. Diffuse large B-cell lymphoma is the most commonly diagnosed histological subtype of canine lymphoma and is treated with anthracyclines alone or in combination with other chemotherapeutics. A new diagnostic marker of prognostic and predictive value is topoisomerase IIα, which also constitutes a molecular target for anti-cancer drugs belonging to the group of topoisomerase IIα inhibitors including anthracyclines. Proliferative activity was estimated in samples of enlarged lymph nodes in dogs with diffuse large B-cell lymphoma based on mitotic count and immunohistochemical evaluation of topoisomerase IIα and Ki67 antigen expression with a view to qualifying patients for anthracycline-base chemotherapy. It has been shown that higher levels of topoisomerase IIα expression corresponded to a higher mitotic count but not to Ki67 index. These results indicate that an immunohistochemical evaluation of topoisomerase IIα expression can be used to develop a diagnostic-clinical protocol for the treatment of dogs with diffuse large B-cell lymphoma using anthracycline-based chemotherapy. Abstract Different types of canine lymphoma respond differently to chemotherapy and have different prognoses. Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma in dogs. Topoisomerase II alpha (TOPIIα) protein has been shown to be a proliferation marker associated with prognostic significance. The aim of the study was to determine the relationship between TOPIIα expression, mitotic count (MC), and Ki67 antigen index in DLBCL in dogs, taking into account the applicability of these parameters to select the chemotherapy protocol with emphasis on the use of anthracycline drugs. Samples of formalin-fixed paraffin-embedded lymph nodes from 34 dogs with DLBCL were immunohistochemically labelled with anti-TOPIIα and Ki67. The number of positive cells and the intensity of the reaction were taken into account in order to assess TOPIIα expression. MC was estimated in the hematoxylin and eosin-stained slides in the area of 2.37 mm2. Positive association between TOPIIα and MC, but no association between TOPIIα and Ki67 was found. It can be concluded that the immunohistochemical determination of TOPIIα as a molecular target for drugs from the anthracycline group may be used in association with MC to establish a diagnostic-clinical protocol for selecting dogs with DLBCL for treatment with anthracycline drugs.
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Affiliation(s)
- Paweł Klimiuk
- Veterinary Diagnostic Laboratory VetDiagnostyka, 20-418 Lublin, Poland
- Correspondence: ; Tel.: +48-510-141-271
| | - Wojciech Łopuszyński
- Sub-Department of Pathomorphology and Forensic Veterinary Medicine, Department and Clinic of Animal Internal Diseases, University of Life Sciences in Lublin, 20-601 Lublin, Poland; (W.Ł.); (K.B.)
| | - Kamila Bulak
- Sub-Department of Pathomorphology and Forensic Veterinary Medicine, Department and Clinic of Animal Internal Diseases, University of Life Sciences in Lublin, 20-601 Lublin, Poland; (W.Ł.); (K.B.)
| | - Adam Brzana
- Regional Veterinary Inspectorate in Opole, Regional Veterinary Laboratory, 45-836 Opole, Poland;
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Henriques J, Felisberto R, Constantino-Casas F, Cabeçadas J, Dobson J. Peripheral blood cell ratios as prognostic factors in canine diffuse large B-cell lymphoma treated with CHOP protocol. Vet Comp Oncol 2020; 19:242-252. [PMID: 33247533 DOI: 10.1111/vco.12668] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/07/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common haematopoietic tumour in dogs and recognized as clinical model for its human counterpart. Recently, neutrophil-to-lymphocyte (NLR) and lymphocyte-to-monocyte (LMR) ratios have been shown to predict time-to-progression (TTP) and lymphoma-specific survival (LSS) in dogs with DLBCL treated with CHOP-based chemotherapy. We retrospectively evaluated in 59 dogs diagnosed with DLBCL the prognostic value of haematological parameters and derived ratios: NLR, LMR, platelet-to-lymphocyte (PLR) and platelet-to-neutrophil (PNR) ratios for TTP, LSS and associated secondary end-points (time-to-progression-rate [TTPR] and lymphoma-specific survival-rate [LSSR]) as rates at 180 and 365 days. PNR is an independent prognostic marker (p ≤ .001) for TTPR/180 and 365 days, dogs with a PNR above 0.032 were more likely to progress before 180 days (sensitivity 46.5%, specificity 87.5%, p = .004). On univariate analysis, NLR showed a prognostic significance for LSSR/180 (p = .006) and LSSR/365 (p = .009). A baseline NLR value below 7.45 was positively associated with survival at 180 days (sensitivity 52%, specificity 85.3%, p = .025). The presence of substage b, was associated with early progression and decreased survival at 180 days (p = .031). Anaemia significantly reduced LSSR at 365 days (p = .028). This is the first study evaluating PLR and PNR in canine DLBCL and demonstrates that PNR could be a predictor of early lymphoma progression. Since peripheral blood cell composition can be affected by several non-oncological causes, the development of larger multicenter studies with homogeneous inclusion criteria could help to better determine the true predictive values of blood cell ratios in dogs' DLBCL treated with CHOP chemotherapy.
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Affiliation(s)
| | | | | | - José Cabeçadas
- Instituto Português de Oncologia de Lisboa, Serviço de Anatomia Patológica, IPO-FG-Lisboa, Lisbon, Portugal
| | - Jane Dobson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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Liquid biopsy based on small extracellular vesicles predicts chemotherapy response of canine multicentric lymphomas. Sci Rep 2020; 10:20371. [PMID: 33230132 PMCID: PMC7683601 DOI: 10.1038/s41598-020-77366-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 11/04/2020] [Indexed: 12/11/2022] Open
Abstract
Lymphoma is the most common type of canine hematological malignancy where the multicentric (cMCL) form accounts for 75% of all cases. The standard treatment is the CHOP chemotherapy protocols that include cyclophosphamide, doxorubicin, vincristine and prednisone, where the majority of dogs achieve complete/partial response; however, it is very important to predict non-responsive cases to improve treatment and to develop new targeted therapies. Here we evaluate a liquid biopsy approach based on serum Small Extracellular Vesicles enriched for exosomes (SEVs) to predict cMCL chemotherapy response. Nineteen dogs at the end of the 19-week chemotherapy protocol (8 Complete Response and 11 Progressive Disease) were evaluated for serum SEVs size, concentration and screened for 95 oncomirs. PD patients had higher SEVs concentration at the diagnosis than CR patients (P = 0.034). The ROC curve was significant for SEVs concentration to predict the response to CHOP (AUC = 0.8011, P = 0.0287). A potential molecular signature based on oncomirs from SEVs (caf-miR-205, caf-miR-222, caf-mir-20a and caf-miR-93) is proposed. To the best of our knowledge, this is the first study demonstrating the potential of a liquid biopsy based on SEVs and their miRNAs content to predict the outcome of chemotherapy for canine multicentric lymphomas.
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12
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Cawley JR, Wright ZM, Meleo K, Post GS, Clifford CA, Vickery KR, Vail DM, Bergman PJ, Thamm DH. Concurrent use of rabacfosadine and L-asparaginase for relapsed or refractory multicentric lymphoma in dogs. J Vet Intern Med 2020; 34:882-889. [PMID: 32064697 PMCID: PMC7096650 DOI: 10.1111/jvim.15723] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/24/2020] [Indexed: 01/14/2023] Open
Abstract
Background Rabacfosadine (RAB), a novel antineoplastic agent conditionally licensed for the treatment of lymphoma in dogs, is efficacious in both naïve and previously treated dogs. Its use in combination with L‐asparaginase (L‐ASP) has not been studied. Hypothesis/Objectives To evaluate the safety and efficacy of L‐ASP given concurrently with RAB in dogs with relapsed multicentric lymphoma. Animals Fifty‐two dogs with relapse of lymphoma after treatment with at least 1 doxorubicin‐based chemotherapy protocol. Methods Open‐label, multicenter, prospective single‐arm clinical trial. Dogs were treated with RAB at 1.0 mg/kg IV every 21 days for up to a total of 5 doses. L‐asparaginase was administered at 400 IU/kg SQ concurrently with the first 2 treatments of RAB. Results The overall response rate (ORR) for all dogs was 67%, with 19 dogs (41%) achieving a complete response (CR). The median progression‐free survival time (MPFS) was 63 days (range 5‐428 days). Dogs experiencing a CR as their best response had an MPFS of 144 days (range 44‐428 days). Adverse events were similar to previous studies evaluating single agent RAB. Failure to achieve a CR and having previously received L‐ASP were negative prognostic factors on multivariate analysis. Conclusions and Clinical Importance Concurrent RAB/L‐ASP appears to be both efficacious and safe for treating relapsed multicentric lymphoma in dogs. Adverse events were most often mild and no unexpected toxicoses were observed.
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Affiliation(s)
- Jacob R Cawley
- Department of Clinical Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
| | | | | | | | | | | | - David M Vail
- School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Douglas H Thamm
- Department of Clinical Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado.,Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, Colorado.,Developmental Therapeutics Program, Comprehensive Cancer Center, University of Colorado, Aurora, Colorado
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13
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Parissenti AM, Pritzker LB, Guo B, Narendrula R, Wang SX, Lin LL, Pei J, Skowronski K, Bienzle D, Woods JP, Pritzker KPH, Coomber BL. RNA disruption indicates CHOP therapy efficacy in canine lymphoma. BMC Vet Res 2019; 15:453. [PMID: 31842875 PMCID: PMC6916446 DOI: 10.1186/s12917-019-2189-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 11/25/2019] [Indexed: 01/21/2023] Open
Abstract
Background Assessment of the efficacy of a multi-agent chemotherapy protocol in which cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) are administered in canine lymphoma is generally performed by physical measurement of lymph node diameter. However, no consistent correlation has been made with prognostic indicators and the length or absence of clinical remission based on lymph node size. RNA disruption measured mid-therapy has been correlated with increased disease-free survival in recent studies of human cancer and was assessed in this study of canine lymphoma patients. Fine needle aspirate samples were taken before treatment and at weeks 3, 6, and 11 of CHOP therapy. RNA was isolated from these samples and assessed using an Agilent Bioanalyzer. RNA disruption assay (RDA) analysis was performed on the data from the resulting electropherograms. Results An increased RNA disruption index (RDI) score was significantly associated with improved progression-free survival. Conclusions Predicting the risk of early relapse during chemotherapy could benefit veterinary patients by reducing ineffective treatment and could allow veterinary oncologists to switch earlier to a more effective drug regimen.
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Affiliation(s)
- Amadeo M Parissenti
- Departments of Biology, Chemistry and Biochemistry, Laurentian University, 935 Ramsey Lake Rd., Sudbury, ON, P3E 2C6, Canada. .,Rna Diagnostics, c/o Health Sciences North Research Institute, 2nd Floor North, 56 Walford Road, Sudbury, ON, P3E 2H3, Canada.
| | - Laura B Pritzker
- Rna Diagnostics, 21 St. Clair Avenue East, Suite 701, Toronto, ON, M4T 1L9, Canada
| | - Baoqing Guo
- Rna Diagnostics, c/o Health Sciences North Research Institute, 2nd Floor North, 56 Walford Road, Sudbury, ON, P3E 2H3, Canada
| | - Rashmi Narendrula
- Rna Diagnostics, c/o Health Sciences North Research Institute, 2nd Floor North, 56 Walford Road, Sudbury, ON, P3E 2H3, Canada
| | - Shirly Xiaohui Wang
- Rna Diagnostics, 21 St. Clair Avenue East, Suite 701, Toronto, ON, M4T 1L9, Canada
| | - Lin Laura Lin
- Rna Diagnostics, 21 St. Clair Avenue East, Suite 701, Toronto, ON, M4T 1L9, Canada
| | - Jingchun Pei
- Rna Diagnostics, 21 St. Clair Avenue East, Suite 701, Toronto, ON, M4T 1L9, Canada
| | - Karolina Skowronski
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Dorothee Bienzle
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - J Paul Woods
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Kenneth P H Pritzker
- Rna Diagnostics, 21 St. Clair Avenue East, Suite 701, Toronto, ON, M4T 1L9, Canada
| | - Brenda L Coomber
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
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Boyé P, Floch F, Serres F, Geeraert K, Clerson P, Siomboing X, Bergqvist M, Sack G, Tierny D. Evaluation of serum thymidine kinase 1 activity as a biomarker for treatment effectiveness and prediction of relapse in dogs with non-Hodgkin lymphoma. J Vet Intern Med 2019; 33:1728-1739. [PMID: 31129922 PMCID: PMC6639481 DOI: 10.1111/jvim.15513] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 05/01/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Serum thymidine kinase 1 (sTK1) activity is closely correlated with DNA synthesis. OBJECTIVES Evaluate sTK1 activity as a biomarker for treatment response and early detection of relapse in dogs with lymphoma. ANIMALS Ninety-seven client-owned dogs with naive or relapsed lymphoma and 23 healthy dogs. METHODS Prospective study. Serum TK1 activity measured by refined ELISA-based method (DiviTum assay, Biovica International) before treatment, at clinical response, and every 4 weeks until relapse or last follow-up. RESULTS Serum TK1 activity was ≤20 Du/L in 96% (22/23) of healthy dogs. Pretreatment sTK1 activity was >20 Du/L in 88% (85/97) dogs with lymphoma. At clinical response, sTK1 activity was significantly lower in dogs with complete (CR, n = 36) versus partial (PR, n = 29) response (P < .0001). Sensitivity (Se) and specificity (Sp) of sTK1 activity for detecting nonfully responders were 76% and 100%, respectively, with cutoff of 119.5 Du/L (AUC, 0.90; 95%-CI, 0.81-0.98; P < .0001). In dogs with CR, a 5-fold increase in sTK1 activity at a 4-week interval predicted relapse at the subsequent 4-week assessment with a Se 50% and Sp 94% (AUC, 0.72; 95%-CI, 0.55-0.90; P = .02). An increase of sTK1 activity (>2.7-fold value measured at clinical response) predicted relapse at subsequent 4-week assessment with a Se 61% and Sp 88% (AUC, 0.79; 95%-CI, 0.64-0.95; P = .004). CONCLUSIONS AND CLINICAL IMPORTANCE Monitoring sTK1 activity could help to detect complete responders and early disease progression in dogs with lymphoma.
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Affiliation(s)
- Pierre Boyé
- Department of Medical Oncology, Oncovet, Villeneuve d'Ascq, France.,OCR (Oncovet-Clinical-Research), Loos, France
| | - Franck Floch
- Department of Medical Oncology, Oncovet, Villeneuve d'Ascq, France
| | - François Serres
- Department of Medical Oncology, Oncovet, Villeneuve d'Ascq, France.,OCR (Oncovet-Clinical-Research), Loos, France
| | - Kévyn Geeraert
- Department of Medical Oncology, Oncovet, Villeneuve d'Ascq, France
| | | | | | | | | | - Dominique Tierny
- Department of Medical Oncology, Oncovet, Villeneuve d'Ascq, France.,OCR (Oncovet-Clinical-Research), Loos, France
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15
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16
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Morgan E, O'Connell K, Thomson M, Griffin A. Canine T cell lymphoma treated with lomustine, vincristine, procarbazine, and prednisolone chemotherapy in 35 dogs. Vet Comp Oncol 2018; 16:622-629. [DOI: 10.1111/vco.12430] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/02/2018] [Accepted: 07/04/2018] [Indexed: 12/12/2022]
Affiliation(s)
- E. Morgan
- Department of Oncology; Animal Referral Hospital Brisbane; Brisbane Australia
| | - K. O'Connell
- Department of Oncology; Animal Referral Hospital Brisbane; Brisbane Australia
| | - M. Thomson
- Department of Oncology; Animal Referral Hospital Brisbane; Brisbane Australia
| | - A. Griffin
- Department of Oncology; Animal Referral Hospital Brisbane; Brisbane Australia
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17
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Large granular leukemia with concurrent central nervous system and articular infiltration in a cat. REVUE VÉTÉRINAIRE CLINIQUE 2018. [PMCID: PMC7148674 DOI: 10.1016/j.anicom.2018.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A 2-year-old female domestic shorthair cat was referred with a 2 month history of lethargy, weight loss, recurrent hyperthermia and polyarthropathy despite prednisolone. Upon physical examination, the cat showed apathy, hyperthermia, multiple appendicular joint pain and swelling. The CBC showed severe macrocytic normochromic non-regenerative anemia and thrombocytopenia. A population of immature large granular lymphocytes (LGL) was noted on blood smear. Abdominal ultrasonography revealed enlarged mesenteric lymph nodes (LNs), hyper echoic liver and splenomegaly. Cytology of fine needle aspirate of synovial fluid, spleen, liver, enlarged abdominal LNs and bone marrow supported a diagnosis of LGL leukemia with concurrent articular infiltration. A COP-based protocol was initiated with L-asparaginase (400 UI/kg intramuscularly) and prednisolone (1 mg/kg/day orally). However, the cat presented 1 week later with obtundation and paresis, indicating the involvement of the central nervous system (CNS). LGL were also observed on cerebrospinal fluid analysis. Histologic examination noted LGL in the spleen, liver and LNs. Immunohistochemistry (IHC) yielded negative results for both B- and T-cells thus suggesting NK-cells. The diagnosis was LGL leukemia with concurrent articular and CNS involvement. Articular infiltration with LGL is rarely reported in small animals, whereas CNS involvement was previously only suspected in a cat at necropsy.
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18
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Moore AS, Frimberger AE. Usefulness of chemotherapy for the treatment of very elderly dogs with multicentric lymphoma. J Am Vet Med Assoc 2018; 252:852-859. [DOI: 10.2460/javma.252.7.852] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Hume KR, Sylvester SR, Borlle L, Balkman CE, McCleary-Wheeler AL, Pulvino M, Casulo C, Zhao J. Metabolic Abnormalities Detected in Phase II Evaluation of Doxycycline in Dogs with Multicentric B-Cell Lymphoma. Front Vet Sci 2018. [PMID: 29536017 PMCID: PMC5834767 DOI: 10.3389/fvets.2018.00025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Doxycycline has antiproliferative effects in human lymphoma cells and in murine xenografts. We hypothesized that doxycycline would decrease canine lymphoma cell viability and prospectively evaluated its clinical tolerability in client-owned dogs with spontaneous, nodal, multicentric, substage a, B-cell lymphoma, not previously treated with chemotherapy. Treatment duration ranged from 1 to 8 weeks (median and mean, 3 weeks). Dogs were treated with either 10 (n = 6) or 7.5 (n = 7) mg/kg by mouth twice daily. One dog had a stable disease for 6 weeks. No complete or partial tumor responses were observed. Five dogs developed grade 3 and/or 4 metabolic abnormalities suggestive of hepatopathy with elevations in bilirubin, ALT, ALP, and/or AST. To evaluate the absorption of oral doxycycline in our study population, serum concentrations in 10 treated dogs were determined using liquid chromatography tandem mass spectrometry. Serum levels were variable and ranged from 3.6 to 16.6 µg/ml (median, 7.6 µg/ml; mean, 8.8 µg/ml). To evaluate the effect of doxycycline on canine lymphoma cell viability in vitro, trypan blue exclusion assay was performed on canine B-cell lymphoma cell lines (17-71 and CLBL) and primary B-cell lymphoma cells from the nodal tissue of four dogs. A doxycycline concentration of 6 µg/ml decreased canine lymphoma cell viability by 80%, compared to matched, untreated, control cells (mixed model analysis, p < 0.0001; Wilcoxon signed rank test, p = 0.0313). Although the short-term administration of oral doxycycline is not associated with the remission of canine lymphoma, combination therapy may be worthwhile if future research determines that doxycycline can alter cell survival pathways in canine lymphoma cells. Due to the potential for metabolic abnormalities, close monitoring is recommended with the use of this drug in tumor-bearing dogs. Additional research is needed to assess the tolerability of chronic doxycycline therapy.
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Affiliation(s)
- Kelly R Hume
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Skylar R Sylvester
- College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Lucia Borlle
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Cheryl E Balkman
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Angela L McCleary-Wheeler
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Mary Pulvino
- Department of Biomedical Genetics, University of Rochester Medical Center, Rochester, NY, United States
| | - Carla Casulo
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
| | - Jiyong Zhao
- Department of Biomedical Genetics, University of Rochester Medical Center, Rochester, NY, United States.,Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
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20
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Fournier Q, Serra J, Handel I, Lawrence J. Impact of Pretreatment Neutrophil Count on Chemotherapy Administration and Toxicity in Dogs with Lymphoma Treated with CHOP Chemotherapy. J Vet Intern Med 2018; 32:384-393. [PMID: 29205493 PMCID: PMC5787211 DOI: 10.1111/jvim.14895] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 10/26/2017] [Accepted: 11/06/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Prechemotherapy absolute neutrophil count (ANC) cutoffs are arbitrary and vary across institutions and clinicians. Similarly, subjective guidelines are utilized for the administration of prophylactic antibiotics in neutropenic dogs. OBJECTIVES To evaluate the impact of various ANC cutoffs on chemotherapy administration in dogs with lymphoma treated with CHOP chemotherapy and to determine whether an association between prechemotherapy ANC and subsequent toxicity exists. The secondary objective was to evaluate a currently used ANC cutoff to indicate prescription of prophylactic antibiotics. ANIMALS Dogs diagnosed with lymphoma treated with CHOP chemotherapy (n = 64). METHODS Six hundred and fifteen ANCs were stratified into 6 classes. The 3 ANC cutoffs 1.5 × 103 /μL, 2.0 × 103 /μL, and 2.5 × 103 /μL were assessed. The presence of an association between prechemotherapy ANC class and toxicity was determined. Afebrile neutropenic dogs with ANC <1.5 × 103 /μL but above the criteria for prophylactic antibiotics were evaluated. RESULTS Chemotherapy was not administered in 7% of visits with an ANC cutoff of 1.5 × 103 /μL; chemotherapy would not have been administered in 10% and 16% of visits with an ANC cutoff of 2.0 × 103 /μL or 2.5 × 103 /μL, respectively. There was no association among the 3 lower prechemotherapy ANC classes and toxicity. All dogs with ANC 0.75-1.5 × 103 /μL recovered spontaneously without medical intervention. CONCLUSION AND CLINICAL IMPORTANCE The number of dose delays was minimized with a prechemotherapy ANC cutoff of 1.5 × 103 /μL, and the prechemotherapy ANC class 1.5-1.99 × 103 /μL was not associated with an increased toxicity. Further investigation of an ANC cutoff near 0.75 × 103 /μL in which to prescribe prophylactic antibiotics is indicated.
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Affiliation(s)
- Q. Fournier
- Royal (Dick) School of Veterinary StudiesRoslin InstituteThe University of EdinburghRoslinUK
| | - J.‐C. Serra
- Royal (Dick) School of Veterinary StudiesRoslin InstituteThe University of EdinburghRoslinUK
| | - I. Handel
- Royal (Dick) School of Veterinary StudiesRoslin InstituteThe University of EdinburghRoslinUK
| | - J. Lawrence
- Royal (Dick) School of Veterinary StudiesRoslin InstituteThe University of EdinburghRoslinUK
- Present address:
Lawrence is presently affiliated with Department of Veterinary Clinical SciencesCollege of Veterinary MedicineUniversity of MinnesotaSaint PaulMN
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21
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Treggiari E, Elliott JW, Baines SJ, Blackwood L. Temozolomide alone or in combination with doxorubicin as a rescue agent in 37 cases of canine multicentric lymphoma. Vet Comp Oncol 2017; 16:194-201. [PMID: 28766920 DOI: 10.1111/vco.12335] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 05/28/2017] [Accepted: 06/26/2017] [Indexed: 12/22/2022]
Affiliation(s)
- E. Treggiari
- Small Animal Teaching Hospital; University of Liverpool, School of Veterinary Science; Neston Cheshire UK
- Willows Veterinary Centre and Referral Service; Solihull West Midlands UK
| | - J. W. Elliott
- Small Animal Teaching Hospital; University of Liverpool, School of Veterinary Science; Neston Cheshire UK
- Willows Veterinary Centre and Referral Service; Solihull West Midlands UK
| | - S. J. Baines
- Willows Veterinary Centre and Referral Service; Solihull West Midlands UK
| | - L. Blackwood
- Small Animal Teaching Hospital; University of Liverpool, School of Veterinary Science; Neston Cheshire UK
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22
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Wilson-Robles H, Budke CM, Miller T, Dervisis N, Novosad A, Wright Z, Thamm DH, Vickery K, Burgess K, Childress M, Lori J, Saba C, Rau S, Silver M, Post G, Reeds K, Gillings S, Schleis S, Stein T, Brugmann B, DeRegis C, Smrkovski O, Lawrence J, Laver T. Geographical differences in survival of dogs with non-Hodgkin lymphoma treated with a CHOP based chemotherapy protocol. Vet Comp Oncol 2017; 15:1564-1571. [PMID: 28419683 DOI: 10.1111/vco.12302] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 12/07/2016] [Accepted: 12/12/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND In humans geographical differences in the incidence and presentation of various cancers have been reported. However, much of this information has not been collected in veterinary oncology. AIM The purpose of this study was to determine if a geographic difference in progression free survival exists for dogs with lymphoma treated within the US. MATERIALS AND METHODS Medical records of 775 cases of canine lymphoma from 3 US regions (west, south and north), treated with CHOP chemotherapy, were retrospectively evaluated. Cases were collected from referral institutions and were required to have received at least one doxorubicin treatment and have follow up information regarding time to progression. RESULTS Significant differences in sex (p = 0.05), weight (p = 0.049), stage (p < 0.001), immunophenotype (p = <0.001), and number of doxorubicin doses (p = 0.001) were seen between regions. Upon univariate analysis, progression free survival (PFS) differed by region (p = 0.006), stage (p = 0.009), sub-stage (p = 0.0005), and immunophenotype (p = 0.001). A multivariable Cox regression model showed that dogs in the western region had a significantly shorter PFS when compared to the south and east. CONCLUSION PFS was significantly affected by stage, sub-stage and phenotype.
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Affiliation(s)
- H Wilson-Robles
- Small Animal Clinical Sciences Department, College of Veterinary Medicine, Texas A&M University, College Station, Texas
| | - C M Budke
- Veterinary Integrative Biosciences Department, College of Veterinary Medicine, Texas A&M University, College Station, Texas
| | - T Miller
- Small Animal Clinical Sciences Department, College of Veterinary Medicine, Texas A&M University, College Station, Texas
| | - N Dervisis
- Small Animal Clinical Sciences Department, Veterinary Medical Center, Michigan State University, East Lansing, Michigan
| | - A Novosad
- Sugar Land Veterinary Specialists and Emergency Care, Sugar Land, Texas
| | - Z Wright
- VCA Animal Diagnostic Clinic, Dallas, Texas
| | - D H Thamm
- Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado
| | - K Vickery
- Hope Veterinary Specialists, Malvern, Pennsylvania
| | - K Burgess
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - M Childress
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
| | - J Lori
- Animal Emergency and Specialty Center, Parker, Colorado
| | - C Saba
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota
| | - S Rau
- Metropolitan Veterinary Associates, Norristown, Pennsylvania
| | - M Silver
- New England Veterinary Oncology Group, Waltham, Massachusetts
| | - G Post
- Department of Oncology, The Veterinary Cancer Center, Norwalk, Connecticut
| | - K Reeds
- Veterinary Clinical Sciences Department, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, Oklahoma
| | - S Gillings
- Summit Veterinary Referral Center, Tacoma, Washington
| | - S Schleis
- Clinical Sciences Department, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | - T Stein
- Medical Sciences Department, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - B Brugmann
- Veterinary Clinical Sciences Department, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - C DeRegis
- Pieper Memorial Veterinary Center, Middletown, Connecticut
| | - O Smrkovski
- Small Animal Clinical Sciences Department, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - J Lawrence
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota
| | - T Laver
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia
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Lautscham EM, Kessler M, Ernst T, Willimzig L, Neiger R. Comparison of a CHOP-LAsp-based protocol with and without maintenance for canine multicentric lymphoma. Vet Rec 2017; 180:303. [DOI: 10.1136/vr.104077] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2016] [Indexed: 11/03/2022]
Affiliation(s)
- E. M. Lautscham
- Small Animal Clinic Hofheim; Katharina-Kemmler-Str. 7 Hofheim 65719 Germany
| | - M. Kessler
- Small Animal Clinic Hofheim; Katharina-Kemmler-Str. 7 Hofheim 65719 Germany
| | - T. Ernst
- Small Animal Clinic Hofheim; Katharina-Kemmler-Str. 7 Hofheim 65719 Germany
| | - L. Willimzig
- Small Animal Clinic Hofheim; Katharina-Kemmler-Str. 7 Hofheim 65719 Germany
| | - R. Neiger
- Small Animal Clinic, Internal Medicine, Justus-Liebig-University Giessen; Frankfurter Str. 126 Giessen 35392 Germany
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Marconato L, Polton GA, Sabattini S, Dacasto M, Garden OA, Grant I, Hendrickx T, Henriques J, Lubas G, Morello E, Stefanello D, Comazzi S. Conformity and controversies in the diagnosis, staging and follow-up evaluation of canine nodal lymphoma: a systematic review of the last 15 years of published literature. Vet Comp Oncol 2016; 15:1029-1040. [DOI: 10.1111/vco.12244] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 04/20/2016] [Accepted: 04/30/2016] [Indexed: 12/14/2022]
Affiliation(s)
| | - G. A. Polton
- North Downs Specialist Referrals; Bletchingley UK
| | - S. Sabattini
- Department of Veterinary Medical Sciences; University of Bologna; Bologna Italy
| | - M. Dacasto
- Department of Comparative Biomedicine and Food Science; University of Padua; Padua Italy
| | - O. A. Garden
- Department of Clinical Science and Services; Immune Regulation Laboratory, Royal Veterinary College; London UK
- Queen Mother Hospital for Animals; Royal Veterinary College; Hatfield UK
| | - I. Grant
- Small Animal Clinical Sciences; School of Veterinary Medicine, University of Glasgow; Glasgow UK
| | | | - J. Henriques
- Hospital Veterinário Berna, OnevetGroup; Lisboa Portugal
| | - G. Lubas
- Department of Veterinary Sciences; University of Pisa; Pisa Italy
| | - E. Morello
- Department of Veterinary Sciences; University of Turin; Turin Italy
| | - D. Stefanello
- Department of Veterinary Medicine; University of Milan; Milan Italy
| | - S. Comazzi
- Department of Veterinary Medicine; University of Milan; Milan Italy
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25
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Goodman IH, Moore AS, Frimberger AE. Treatment of canine non-indolent T cell lymphoma using the VELCAP-TSC protocol: A retrospective evaluation of 70 dogs (2003–2013). Vet J 2016; 211:39-44. [DOI: 10.1016/j.tvjl.2016.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/28/2016] [Accepted: 03/03/2016] [Indexed: 01/19/2023]
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27
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Alexandrakis I, Tuli R, Ractliffe SC, Tappin SW, Foale RD, Roos A, Slater KJ. Utility of a multiple serum biomarker test to monitor remission status and relapse in dogs with lymphoma undergoing treatment with chemotherapy. Vet Comp Oncol 2014; 15:6-17. [PMID: 25319380 DOI: 10.1111/vco.12123] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 09/09/2014] [Accepted: 09/16/2014] [Indexed: 12/22/2022]
Abstract
A blinded retrospective study was conducted to investigate remission and recurrence of lymphoma in dogs receiving chemotherapy. The objective was to compare clinicians' assessment using palpation and cytology to the results of serum biochemical tests for haptoglobin (Hapt) and C-reactive protein (C-RP). These biochemical test results were combined using a diagnostic algorithm developed using data from 344 individual dogs. This multivariate approach, termed the canine lymphoma blood test (cLBT), was used to follow 57 dogs during and after treatment. cLBT of remission and recurrence compared well with clinicians' assessment and differentiated dogs in remission and those with recurring disease before appearance of lymphadenopathy (P < 0.001). The cLBT demonstrated prognostic potential based on pre-treatment values on dogs with shorter survival times and on those achieving the lowest cLBT score during treatment that showed longer survival times. The test, therefore, demonstrates potential to assist in monitoring treatment of canine lymphoma.
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Affiliation(s)
- I Alexandrakis
- Avacta Animal Health Unit 651, Thorp Arch Estate, Wetherby, LS23 7FZ, UK
| | - R Tuli
- Avacta Animal Health Unit 651, Thorp Arch Estate, Wetherby, LS23 7FZ, UK
| | - S C Ractliffe
- Avacta Animal Health Unit 651, Thorp Arch Estate, Wetherby, LS23 7FZ, UK
| | - S W Tappin
- Dick White Referrals Station Farm, Cambridgeshire, CB8 0UH, United Kingdom
| | - R D Foale
- Dick White Referrals Station Farm, Cambridgeshire, CB8 0UH, United Kingdom
| | - A Roos
- Dierenkliniek Korte Akkeren, Gouda, Netherlands
| | - K J Slater
- Avacta Animal Health Unit 651, Thorp Arch Estate, Wetherby, LS23 7FZ, UK
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Rassnick KM, Bailey DB, Malone EK, Flory AB, Kiselow MA, Intile JL. Tolerability of Lomustine in Combination with Cyclophosphamide in Dogs with Lymphoma. J Am Anim Hosp Assoc 2014; 50:167-73. [DOI: 10.5326/jaaha-ms-6020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This retrospective study describes toxicity associated with a protocol of lomustine (CCNU) and cyclophosphamide (CTX) in dogs with lymphoma. CCNU was administered per os (PO) at a targeted dosage of 60 mg/m2 body surface area on day 0, CTX was administered PO at a targeted dosage of 250 mg/m2 divided over days 0 through 4, and all dogs received prophylactic antibiotics. Ninety treatments were given to the 57 dogs included in the study. Neutropenia was the principal toxic effect, and the overall frequency of grade 4 neutropenia after the first treatment of CCNU/CTX was 30% (95% confidence interval, 19–43%). The mean body weight of dogs with grade 4 neutropenia (19.7 kg ± 13.4 kg) was significantly less than the mean body weight of dogs that did not develop grade 4 neutropenia (31.7 kg ± 12.4 kg; P = .005). One dog (3%) developed hematologic changes suggestive of hepatotoxicity. No dogs had evidence of either renal toxicity or hemorrhagic cystitis. Adverse gastrointestinal effects were uncommon. On the basis of the findings reported herein, a dose of 60 mg/m2 of CCNU combined with 250 mg/m2 of CTX (divided over 5 days) q 4 wk is tolerable in tumor-bearing dogs.
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Affiliation(s)
- Kenneth M. Rassnick
- Veterinary Medical Center of Central New York, East Syracuse, NY (K.R.); Oradell Animal Hospital, Paramus, NJ (D.B.); MedVet Medical and Cancer Center for Pets, Worthington, OH (E.M.); Veterinary Specialty Hospital, San Marcos, CA (A.F.); Sage Centers for Veterinary Specialty and Emergency Care, Campbell, CA (M.K.); and VCA Veterinary Referral Associates, Gaithersburg, MD (J.I.)
| | - Dennis B. Bailey
- Veterinary Medical Center of Central New York, East Syracuse, NY (K.R.); Oradell Animal Hospital, Paramus, NJ (D.B.); MedVet Medical and Cancer Center for Pets, Worthington, OH (E.M.); Veterinary Specialty Hospital, San Marcos, CA (A.F.); Sage Centers for Veterinary Specialty and Emergency Care, Campbell, CA (M.K.); and VCA Veterinary Referral Associates, Gaithersburg, MD (J.I.)
| | - Erin K. Malone
- Veterinary Medical Center of Central New York, East Syracuse, NY (K.R.); Oradell Animal Hospital, Paramus, NJ (D.B.); MedVet Medical and Cancer Center for Pets, Worthington, OH (E.M.); Veterinary Specialty Hospital, San Marcos, CA (A.F.); Sage Centers for Veterinary Specialty and Emergency Care, Campbell, CA (M.K.); and VCA Veterinary Referral Associates, Gaithersburg, MD (J.I.)
| | - Andrea B. Flory
- Veterinary Medical Center of Central New York, East Syracuse, NY (K.R.); Oradell Animal Hospital, Paramus, NJ (D.B.); MedVet Medical and Cancer Center for Pets, Worthington, OH (E.M.); Veterinary Specialty Hospital, San Marcos, CA (A.F.); Sage Centers for Veterinary Specialty and Emergency Care, Campbell, CA (M.K.); and VCA Veterinary Referral Associates, Gaithersburg, MD (J.I.)
| | - Michael A. Kiselow
- Veterinary Medical Center of Central New York, East Syracuse, NY (K.R.); Oradell Animal Hospital, Paramus, NJ (D.B.); MedVet Medical and Cancer Center for Pets, Worthington, OH (E.M.); Veterinary Specialty Hospital, San Marcos, CA (A.F.); Sage Centers for Veterinary Specialty and Emergency Care, Campbell, CA (M.K.); and VCA Veterinary Referral Associates, Gaithersburg, MD (J.I.)
| | - Joanne L. Intile
- Veterinary Medical Center of Central New York, East Syracuse, NY (K.R.); Oradell Animal Hospital, Paramus, NJ (D.B.); MedVet Medical and Cancer Center for Pets, Worthington, OH (E.M.); Veterinary Specialty Hospital, San Marcos, CA (A.F.); Sage Centers for Veterinary Specialty and Emergency Care, Campbell, CA (M.K.); and VCA Veterinary Referral Associates, Gaithersburg, MD (J.I.)
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Barber LG, Weishaar KM. Criteria for designation of clinical substage in canine lymphoma: a survey of veterinary oncologists. Vet Comp Oncol 2014; 14 Suppl 1:32-9. [DOI: 10.1111/vco.12086] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 12/23/2013] [Accepted: 12/27/2013] [Indexed: 11/28/2022]
Affiliation(s)
- L. G. Barber
- Department of Clinical Sciences; Tufts Cummings School of Veterinary Medicine; North Grafton MA USA
| | - K. M. Weishaar
- Department of Clinical Sciences; Tufts Cummings School of Veterinary Medicine; North Grafton MA USA
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Hematopoietic Tumors. WITHROW AND MACEWEN'S SMALL ANIMAL CLINICAL ONCOLOGY 2013. [PMCID: PMC7161412 DOI: 10.1016/b978-1-4377-2362-5.00032-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Fahey CE, Milner RJ, Barabas K, Lurie D, Kow K, Parfitt S, Lyles S, Clemente M. Evaluation of the University of Florida lomustine, vincristine, procarbazine, and prednisone chemotherapy protocol for the treatment of relapsed lymphoma in dogs: 33 cases (2003-2009). J Am Vet Med Assoc 2011; 239:209-15. [PMID: 21756176 DOI: 10.2460/javma.239.2.209] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the toxicity and efficacy of a modification of a previously evaluated combination of lomustine, vincristine, procarbazine, and prednisone (LOPP) as a rescue protocol for refractory lymphoma in dogs. DESIGN Retrospective case series. Animals-33 dogs with a cytologic or histologic diagnosis of lymphoma that developed resistance to their induction chemotherapy protocol. PROCEDURES Lomustine was administered on day 0 of the protocol. Vincristine was administered on day 0 and again 1 time on day 14. Procarbazine and prednisone were administered on days 0 through 13 of the protocol. This cycle was repeated every 28 days. RESULTS Median time from initiation to discontinuation of the University of Florida LOPP protocol was 84 days (range, 10 to 308 days). Overall median survival time was 290 days (range, 51 to 762 days). Overall response rate with this protocol was 61% (20/33), with 36% (12) having a complete response and 24% (8) having a partial response. Toxicosis rates were lower than for the previously published LOPP protocol. CONCLUSIONS AND CLINICAL RELEVANCE The University of Florida LOPP protocol may be an acceptable alternative to the mechlorethamine, vincristine, procarbazine, and prednisone protocol as a rescue protocol for dogs with lymphoma.
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Affiliation(s)
- Christine E Fahey
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA
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Sato M, Yamazaki J, Goto-Koshino Y, Takahashi M, Fujino Y, Ohno K, Tsujimoto H. Evaluation of Cytoreductive Efficacy of Vincristine, Cyclophosphamide, and Doxorubicin in Dogs with Lymphoma by Measuring the Number of Neoplastic Lymphoid Cells with Real-Time Polymerase Chain Reaction. J Vet Intern Med 2011; 25:285-91. [DOI: 10.1111/j.1939-1676.2011.0686.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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