1
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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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2
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Thamm DH. Novel Treatments for Lymphoma. Vet Clin North Am Small Anim Pract 2024; 54:477-490. [PMID: 38199913 DOI: 10.1016/j.cvsm.2023.12.004] [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] [Indexed: 01/12/2024]
Abstract
Lymphoma is a common disease in companion animals. While conventional chemotherapy has the potential to induce remission and prolong life, relapse is common and novel treatments are needed to improve outcome. This review discusses recent modifications/adjustments to conventional standard of care therapy for canine and feline lymphoma, options for treatment or relapsed/refractory disease, and cutting-edge immunotherapy and small molecule-based approaches that are in varying stages of regulatory approval.
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Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523-1620 USA.
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3
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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: 10] [Impact Index Per Article: 10.0] [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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4
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Sargeant JM, Ruple A, Selmic LE, O'Connor AM. The standards of reporting trials in pets (PetSORT): Explanation and elaboration. Front Vet Sci 2023; 10:1137781. [PMID: 37065227 PMCID: PMC10103631 DOI: 10.3389/fvets.2023.1137781] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/01/2023] [Indexed: 04/03/2023] Open
Abstract
Well-designed randomized controlled trials (RCTs) provide the best evidence of the primary research designs for evaluating the effectiveness of interventions. However, if RCTs are incompletely reported, the methodological rigor with which they were conducted cannot be reliably evaluated and it may not be possible to replicate the intervention. Missing information also may limit the reader's ability to evaluate the external validity of a trial. Reporting guidelines are available for clinical trials in human healthcare (CONSORT), livestock populations (REFLECT), and preclinical experimental research involving animals (ARRIVE 2.0). The PetSORT guidelines complement these existing guidelines, providing recommendations for reporting controlled trials in pet dogs and cats. The rationale and scientific background are explained for each of the 25 items in the PetSORT reporting recommendations checklist, with examples from well-reported trials.
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Affiliation(s)
- Jan M. Sargeant
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Audrey Ruple
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
- *Correspondence: Audrey Ruple
| | - Laura E. Selmic
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
| | - Annette M. O'Connor
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
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5
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Chavalle T, Chamel G, Denoeux P, Lajoinie M, Sayag D, Berny P, Ponce F. Are severe adverse events commonly observed in dogs during cancer chemotherapy? A retrospective study on 155 dogs. Vet Comp Oncol 2021; 20:393-403. [PMID: 34775666 DOI: 10.1111/vco.12782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 11/29/2022]
Abstract
Overall prevalence of severe adverse events (sAE) has been poorly studied in veterinary medicine and peer-reviewed studies mostly focused on a single protocol, making it difficult to have a general overview. The aim of this retrospective study was to assess the frequency and risk factors of sAE secondary to various protocols of chemotherapy in dogs. Medical records of 155 dogs receiving chemotherapy between January 2013 and December 2018 were reviewed. Adverse events (AE) were graded according to Veterinary Comparative Oncology Group-common terminology criteria for AE (VCOG-CTCAE) grading system. Statistical analyses were performed to determine whether demographic, cancer type and chemotherapy protocol were associated with development of sAE and their consequences. AE were reported at least once in 124 (80%) dogs and sAE were observed in 50 (32.3%) dogs. Among them, 23 (14.8%) had gastro-intestinal and 31 (20.0%) had myelotoxic events. sAE led to hospitalisation in 37 (23.9%) dogs, to chemotherapy arrest in 12 (7.7%) dogs and to euthanasia or death in 9 (5.8%) dogs. Haematopoietic tumours were statistically associated with a higher frequency of sAE (p = .004), gastrointestinal sAE (p = .009) and hospitalisation (p = .004). A body weight over 10 kg was associated with less haematological sAE (p < .001). The use of a multi-agent protocol was highlighted as a risk factor for sAE (p = .038) and haematological sAE (p < .001). sAE following chemotherapy and leading to hospitalisation, chemo arrest or death were relatively common. A special attention during chemotherapy follow-up should be given to small dogs and those receiving multi-agent protocol or treated for haematopoietic tumours.
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Affiliation(s)
- Thomas Chavalle
- Service de cancérologie, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
| | - Gabriel Chamel
- Service de cancérologie, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France.,UR ICE, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
| | - Pauline Denoeux
- Service de cancérologie, Centre Hospitalier Vétérinaire Atlantia, Nantes, France
| | - Mathilde Lajoinie
- Service de cancérologie, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
| | - David Sayag
- ONCOnseil - Unité d'expertise en oncologie vétérinaire, Toulouse, France
| | - Philippe Berny
- UR ICE, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
| | - Frédérique Ponce
- Service de cancérologie, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France.,UR ICE, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
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6
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Nakagawa T, Kojima M, Ohno K, Chambers JK, Uchida K, Ohmi A, Goto-Koshino Y, Tomiyasu H, Tsujimoto H. Efficacy and adverse events of continuous l-asparaginase administration for canine large cell lymphoma of presumed gastrointestinal origin. Vet Comp Oncol 2021; 20:102-108. [PMID: 34213084 DOI: 10.1111/vco.12749] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/30/2021] [Accepted: 06/30/2021] [Indexed: 11/30/2022]
Abstract
We examined the efficacy and adverse events of continuous l-asparaginase administration in dogs with large cell lymphoma of presumedgastrointestinal (GI) origin. We retrospectively reviewed medical records of dogs with large cell lymphoma of presumed GI origin treated with continuous l-asparaginase administration from 2009 to 2018. We collected information on the signalment, lesion site, complete blood count, serum biochemical profile, diagnostic imaging findings, cytological and histopathological findings, immunophenotype, l-asparaginase administration frequency, treatment response, adverse events, rescue protocol, and patient outcomes. Clinical outcomes were assessed using medical records or by contacting the owner or referring veterinarian. Thirty-two dogs with large cell lymphoma of presumed GI origin received weekly l-asparaginase administration. The median number of l-asparaginase injections was seven (range: 1-30). Although two of the 32 dogs had GI toxicity of grade 3 or higher, none developed a hypersensitivity reaction. The response rate based on ultrasonographic findings was 18/32 (56%) and that based on clinical signs was 30/32 (94%). The median overall progression-free survival was 50 days (range: 2-214 days), and median overall survival was 147 days (range: 2-482 days). Adverse events associated with continuous l-asparaginase administration were rare. Clinical signs at diagnosis improved in most cases. Based on these results, continuous l-asparaginase administration appears to be a reasonable treatment option for dogs with large cell lymphoma of presumed GI origin.
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Affiliation(s)
- Taisuke Nakagawa
- Veterinary Medical Centre, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Mari Kojima
- Veterinary Medical Centre, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Koichi Ohno
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life 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, Japan
| | - Kazuyuki Uchida
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Japan
| | - Aki Ohmi
- Veterinary Medical Centre, 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 Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Hirotaka Tomiyasu
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Hajime Tsujimoto
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
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7
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Parachini-Winter C, Bracha S, Ramsey SA, Yang L, Ho E, Leeper HJ, Curran KM. Prospective evaluation of the lymph node proteome in dogs with multicentric lymphoma supplemented with sulforaphane. J Vet Intern Med 2020; 34:2036-2047. [PMID: 32926463 PMCID: PMC7517837 DOI: 10.1111/jvim.15898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 12/21/2022] Open
Abstract
Background Lymphoma (LSA) is a common malignancy in dogs. Epigenetic changes are linked to LSA pathogenesis and poor prognosis in humans, and LSA pathogenesis in dogs. Sulforaphane (SFN), an epigenetic‐targeting compound, has recently gained interest in relation to cancer prevention and therapy. Objective Examine the impact of oral supplementation with SFN on the lymph node proteome of dogs with multicentric LSA. Animals Seven client‐owned dogs with multicentric LSA. Methods Prospective, nonrandomized, noncontrolled study in treatment‐naïve dogs with intermediate or large cell multicentric LSA. Lymph node cell aspirates were obtained before and after 7 days of oral supplementation with SFN, and analyzed via label‐free mass spectrometry, immunoblots, and Gene Set Enrichment Analysis. Results There was no clinical response and no adverse events attributed to SFN. For individual dogs, the expression of up to 650 proteins changed by at least 2‐fold (range, 2‐100) after supplementation with SFN. When all dogs where analyzed together, 14 proteins were significantly downregulated, and 10 proteins were significantly upregulated after supplementation with SFN (P < .05). Proteins and gene sets impacted by SFN were commonly involved in immunity, response to oxidative stress, gene transcription, apoptosis, protein transport, maturation and ubiquitination. Conclusions and Clinical Importance Sulforaphane is associated with major changes in the proteome of neoplastic lymphocytes in dogs.
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Affiliation(s)
- Cyril Parachini-Winter
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA
| | - Shay Bracha
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA
| | - Stephen A Ramsey
- Department of Biomedical Sciences, School of Electrical Engineering and Computer Science, Oregon State University, Corvallis, Oregon, USA
| | - Liping Yang
- Department of Chemistry, College of Science, Oregon State University, Corvallis, Oregon, USA
| | - Emily Ho
- Linus Pauling Institute and College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Haley J Leeper
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA
| | - Kaitlin M Curran
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA
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8
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Guillen A, Finotello R, Wynne P, Harper A, Killick D, Amores-Fuster I, Blackwood L. Toxicity of cytarabine constant rate infusion in dogs with high-grade non-Hodgkin lymphoma with bone marrow or central nervous system involvement. Aust Vet J 2019; 98:69-78. [PMID: 31769013 DOI: 10.1111/avj.12895] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/27/2019] [Accepted: 10/27/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Cytarabine, a cell-cycle phase-specific antimetabolite, has been reported to improve outcomes in dogs with bone marrow (BM) or central nervous system (CNS) lymphoma involvement receiving combination chemotherapy. The objective of this study was to evaluate the incidence and severity of toxicity of cytarabine constant rate infusion (CRI) in dogs with high-grade non-Hodgkin lymphoma. METHODS Medical records of canine lymphoma patients with confirmed or suspected BM (group 1) or CNS (group 2) involvement, treated with a modified cyclophosphamide, epirubicin, vincristine and prednisolone protocol, including a single dose of cytarabine given as CRI, were reviewed and adverse events graded. RESULTS Twenty-six dogs were included. Gastrointestinal toxicity occurred in 17 dogs (65.3%), with 5 (19.2%) experiencing grade III or IV toxicity. Neutropenia occurred in nine dogs (34.6%), but was grade I or II in most cases. Three dogs (11.5%) had thrombocytopenia: one grade III and two grade IV. Four dogs (15.3%) experienced increases in alanine amino transferase: one each grade I and II and two grade III. Five dogs (19.2%) required hospitalisation to manage toxicity after completing cytarabine CRI, and haematological toxicity resulted in treatment delays in five dogs (median delay of 4 days, range: 3-7 days). CONCLUSION Our findings suggest that gastrointestinal toxicity should be expected in lymphoma patients undergoing cytarabine CRI.
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Affiliation(s)
- A Guillen
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK
| | - R Finotello
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK
| | - P Wynne
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK
| | - A Harper
- Southfields Veterinary Specialists, Southfields, Laindon Essex, SS15 6TP, UK
| | - D Killick
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK
| | - I Amores-Fuster
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK
| | - L Blackwood
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK
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9
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Abstract
Lymphoma is a common disease in companion animals. Although conventional chemotherapy has the potential to induce remission and prolong life, relapse is common, and novel treatments are needed to improve outcome. This review discusses recent modifications/adjustments to conventional standard of care therapy for canine and feline lymphoma, as well as cutting-edge immunotherapy and small-molecule-based approaches that are in varying stages of regulatory approval.
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Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523-1620, USA.
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10
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Smallwood K, Tanis J, Grant IA, Blackwood L, Killick DR, Amores‐Fuster I, Elliott J, Mas A, Harper A, Marrington M, Finotello R. Evaluation of a multi‐agent chemotherapy protocol combining dexamethasone, melphalan, actinomycin D, and cytarabine for the treatment of resistant canine non‐Hodgkin high‐grade lymphomas: a single centre's experience. Vet Comp Oncol 2019; 17:165-173. [DOI: 10.1111/vco.12457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/11/2019] [Accepted: 01/16/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Katherine Smallwood
- Department of Small Animal Clinical Science, Institute of Veterinary ScienceUniversity of Liverpool, Leahurst Campus Neston UK
| | - Jean‐Benoit Tanis
- Department of Small Animal Clinical Science, Institute of Veterinary ScienceUniversity of Liverpool, Leahurst Campus Neston UK
| | - Iain A. Grant
- Department of Small Animal Clinical Science, Institute of Veterinary ScienceUniversity of Liverpool, Leahurst Campus Neston UK
| | - Laura Blackwood
- Department of Small Animal Clinical Science, Institute of Veterinary ScienceUniversity of Liverpool, Leahurst Campus Neston UK
| | - David R. Killick
- Department of Small Animal Clinical Science, Institute of Veterinary ScienceUniversity of Liverpool, Leahurst Campus Neston UK
| | - Isabel Amores‐Fuster
- Department of Small Animal Clinical Science, Institute of Veterinary ScienceUniversity of Liverpool, Leahurst Campus Neston UK
| | - James Elliott
- Department of Small Animal Clinical Science, Institute of Veterinary ScienceUniversity of Liverpool, Leahurst Campus Neston UK
| | - Aran Mas
- Department of Small Animal Clinical Science, Institute of Veterinary ScienceUniversity of Liverpool, Leahurst Campus Neston UK
| | - Aaron Harper
- Department of Small Animal Clinical Science, Institute of Veterinary ScienceUniversity of Liverpool, Leahurst Campus Neston UK
| | - Mary Marrington
- Department of Small Animal Clinical Science, Institute of Veterinary ScienceUniversity of Liverpool, Leahurst Campus Neston UK
| | - Riccardo Finotello
- Department of Small Animal Clinical Science, Institute of Veterinary ScienceUniversity of Liverpool, Leahurst Campus Neston UK
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11
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Al-Nadaf S, Rebhun RB, Curran KM, Venable RO, Skorupski KA, Willcox JL, Burton JH. Retrospective analysis of doxorubicin and prednisone as first-line therapy for canine B-cell lymphoma. BMC Vet Res 2018; 14:356. [PMID: 30458771 PMCID: PMC6245930 DOI: 10.1186/s12917-018-1688-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 11/06/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A doxorubicin (DOX)-based chemotherapy protocol, CHOP, is the most effective treatment for canine high-grade B-cell lymphoma; however, the cost and time requirements associated with this protocol are not feasible for many pet owners. An alternative treatment option is the use of DOX, the most effective drug, in combination with prednisone. Prior studies with single-agent DOX included dogs with T-cell lymphoma, a known negative prognostic factor, which may have resulted in shorter reported survival times than if dogs with B-cell lymphoma were analyzed separately. The purpose of this study was to evaluate the outcome of dogs with high-grade B-cell lymphoma when treated with DOX and prednisone with or without L-asparaginase (L-ASP). Identification of prognostic factors was of secondary interest. RESULTS Thirty-three dogs were included in the study; 31 dogs were evaluable for response with an overall response rate of 84%. The median progression free survival (PFS) and overall survival (OS) were 147 days and 182 days, respectively. The one-year survival fraction was 23%. No variable other than protocol completion was found to be significant for either PFS or OS including historical prognostic factors such as substage, thrombocytopenia, and body weight. CONCLUSIONS Dogs with high-grade B-cell lymphoma treated with DOX and prednisone with or without L-ASP have similar response rates, PFS, and OS to prior studies that did not differentiate between lymphoma immunophenotype. This protocol is not a replacement for CHOP; however, it is an alternative if time and cost are factors, while providing therapeutic benefit greater than prednisone alone.
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Affiliation(s)
- Sami Al-Nadaf
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Robert B Rebhun
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Kaitlin M Curran
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | | | - Katherine A Skorupski
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Jennifer L Willcox
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Jenna H Burton
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.
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12
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Tanis JB, Mason SL, Maddox TW, Blackwood L, Killick DR, Amores-Fuster I, Harper A, Finotello R. Evaluation of a multi-agent chemotherapy protocol combining lomustine, procarbazine and prednisolone (LPP) for the treatment of relapsed canine non-Hodgkin high-grade lymphomas. Vet Comp Oncol 2018; 16:361-369. [PMID: 29380942 DOI: 10.1111/vco.12387] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/22/2017] [Accepted: 01/04/2018] [Indexed: 11/27/2022]
Abstract
The standard of care treatment for canine lymphoma is multi-agent chemotherapy containing prednisolone, cyclophosphamide, vincristine and an anthracycline such as doxorubicin (CHOP) or epirubicin (CEOP). Lomustine, vincristine, procarbazine, and prednisone (LOPP) has been evaluated as a rescue, with encouraging results; however, resistance to vincristine is likely in patients relapsing on CHOP/CEOP, and this agent may enhance LOPP toxicity without improving efficacy. The aim of this study was to evaluate responses to a modified-LOPP protocol that does not include vincristine (LPP) and is administered on a 21-day cycle. Medical records of dogs with high-grade multicentric lymphoma from 2012 to 2017 were reviewed. Dogs with relapsed lymphoma that received LPP as a rescue protocol were enrolled. Response, time from initiation to discontinuation (TTD) and toxicity of LPP were assessed. Forty-one dogs were included. Twenty-five dogs (61%) responded to LPP including 12 complete responses (CR) and 13 partial responses (PR). Responders had a significantly longer TTD (P < .001) compared to non-responders with 84 days for CR and 58 days for PR. Neutropenia was documented in 20 dogs (57%): 12 grade I to II, 8 grade III to IV. Thrombocytopenia was infrequent (20%): 5 grade I to II, 2 grade III to IV. Twelve dogs developed gastrointestinal toxicity (30%): 10 grade I to II and 2 grade III. Nineteen dogs had elevated ALT (59%): 9 grade I to II, 10 grade III to IV. Treatment was discontinued due to toxicity in 8 dogs (19%). The LPP protocol shows acceptable efficacy and toxicity-profile and minimizes in-hospital procedures.
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Affiliation(s)
- J-B Tanis
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Liverpool, UK
| | - S L Mason
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - T W Maddox
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Liverpool, UK
| | - L Blackwood
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Liverpool, UK
| | - D R Killick
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Liverpool, UK
| | - I Amores-Fuster
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Liverpool, UK
| | - A Harper
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Liverpool, UK
| | - R Finotello
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Liverpool, UK
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13
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Childress MO, Ramos-Vara JA, Ruple A. Retrospective analysis of factors affecting clinical outcome following CHOP-based chemotherapy in dogs with primary nodal diffuse large B-cell lymphoma. Vet Comp Oncol 2017; 16:E159-E168. [PMID: 29152834 DOI: 10.1111/vco.12364] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 12/14/2022]
Abstract
Numerous factors are known to affect the prognosis of dogs with chemotherapy-treated lymphomas. However, prognostic factors for dogs with specific subtypes of lymphoma are less clearly defined. The objective of this study was to identify prognostic factors for dogs receiving CHOP-based chemotherapy for primary nodal diffuse large B-cell lymphoma (DLBCL). Medical records of dogs treated for DLBCL at the Purdue Veterinary Teaching Hospital (PUVTH) from 2006 to 2016 were reviewed. Factors potentially related to prognosis were analysed using multivariable statistical methods. Ninety-eight dogs were included in the study. Best overall response to chemotherapy was complete remission in 80 dogs (81.6%) and partial remission in 18 dogs (18.4%). Median progression-free survival (PFS) for the entire population was 252 days (range 19-1068). Factors significantly associated with achieving partial (rather than complete) remission following CHOP included presence of thrombocytopenia at diagnosis (OR 6.88; 95% CI 1.98-23.93; P = .002), baseline serum globulin concentration (OR 2.63; 95% CI 1.03-6.75; P = .044), and age at diagnosis (OR 1.36; 95% CI 1.08-1.71; P = .009). Factors significantly associated with PFS in the lowest quartile (≤93 days) included presence of thrombocytopenia at diagnosis (OR 8.72; 95% CI 1.54-49.33; P = .014), age at diagnosis (OR 1.47; 95% CI 1.12-1.94; P = .005), and baseline neutrophil count (OR 1.18; 95% CI 1.02-1.37; P = .025). Presence of thrombocytopenia, greater age, higher neutrophil count, and higher serum globulin concentration all may be associated with a particularly poor outcome in dogs receiving CHOP-based chemotherapy for DLBCL.
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Affiliation(s)
- M O Childress
- Departments of Veterinary Clinical Sciences (Childress) and Comparative Pathobiology (Ramos-Vara, Ruple), College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
| | - J A Ramos-Vara
- Departments of Veterinary Clinical Sciences (Childress) and Comparative Pathobiology (Ramos-Vara, Ruple), College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
| | - A Ruple
- Departments of Veterinary Clinical Sciences (Childress) and Comparative Pathobiology (Ramos-Vara, Ruple), College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
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