A Retrospective Study of Multi‐agent Chemotherapy including either Cyclophosphamide or Lomustine as Initial Therapy for Canine High‐grade T‐cell Lymphoma (2011‐2017)

Abstract

Multi-agent chemotherapy (vincristine, epirubicin and prednisolone) including either cyclophosphamide (CEOP) or lomustine (LEOP) was given as first-line chemotherapy to treatment-naïve canine lymphoma patients with measurable, high grade T-cell lymphoma (HGTCL). All patients responded to either CEOP or LEOP. Toxicity was typical of multi-agent chemotherapy protocols and 25% of dogs receiving lomustine exhibited mild-to-moderate ALT elevation and 29% grade 3 or 4 neutropenia. Median progression-free survival (100 versus 269 days) and overall survival (155 versus 327 days) were significantly higher in patients receiving LEOP compared to CEOP. Overall survival was improved for patients receiving LEOP compared to those receiving CEOP followed by lomustine-based rescue therapy. The results of this retrospective study support further evaluation of lomustine as part of first-line, multi-agent therapy for patients with HGTCL.

Prognostic indicators for naïve canine non‐indolent T‐cell lymphoma treated with combination lomustine, vincristine, procarbazine and prednisolone chemotherapy

“…The PFS and OST reported in this cohort are comparable to those previously reported for naïve non‐indolent TCL treated with alkylating agent‐rich chemotherapy protocols 8,17,24 and CHOP‐based chemotherapy protocols 9,15,23,27 . The heterogeneity of patients within these studies does not allow for direct comparison and as such conclusions to whether alkylating agent‐rich protocols confer an improved outcome for dogs with naïve TCL cannot be made 8,18,24–27,42 …”

“…9,15,23,27 The heterogeneity of patients within these studies does not allow for direct comparison and as such conclusions to whether alkylating agent-rich protocols confer an improved outcome for dogs with naïve TCL cannot be made. 8,18,[24][25][26][27]42 Hypercalcaemia has previously been shown to be a negative prognostic indicator for the treatment of canine lymphoma. 6,8,10,16,31 Historical studies that have associated hypercalcaemia with poorer outcomes following treatment with multiagent chemotherapy protocols either did not report immunophenotyping 10,16 or had a low proportion of the population immunophenotyped.…”

“…Some previously identified negative prognostic indicators include hypercalcaemia, 6,8,10 anaemia, 6,9,11–13 T‐cell immunophenotype, 4–6,9,14 increasing WHO stage, 6 substage b, 6,9,15–19 a peripheral lymphocyte to monocyte ratio of ≤1.20, 20 increasing peripheral neutrophil to lymphocyte ratio, 21 non‐multicentric disease distribution 5 and the Boxer breed 3,22 . However, few publications report only on prognostic indicators for naïve TCL 13,23–27 . Furthermore, different histomorphological subtypes have been shown to strongly predict prognosis in TCL 15,28,29 .…”

“…3,22 However, few publications report only on prognostic indicators for naïve TCL. 13,[23][24][25][26][27] Furthermore, different histomorphological subtypes have been shown to strongly predict prognosis in TCL. 15,28,29 Testing of genomic expression may also play a role in prognosis; however, its relevance as a prognostic indicator in TCL remains unknown.…”

Assessment of biomarkers influencing treatment success on small intestinal lymphoma in dogs

“…ABCB1 contributes to the efflux pump‐mediated resistance in multidrug therapy as a CHOP‐based protocol, 14 but it remains unknown how ABCB1 affects the resistance of CCNU, which had little influence on p‐glycoprotein activity. CCNU is widely used as the standard treatment for high‐grade T cell lymphoma because the CCNU‐based protocol could prolong survival longer compared to the CHOP‐based protocol 26,27 . Therefore, MGMT may be a more robust factor than ABCB1.…”