Chemotherapy-induced neutropenia is associated with prolonged remission duration and survival time in canine lymphoma

Wang, Shang-Lin; Lee, J.; Liao, Albert

doi:10.1016/j.tvjl.2015.04.032

Cited by 30 publications

(35 citation statements)

References 26 publications

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“…In addition, excluding treatment delays inherent to the CHOP19 protocol during the weeks following DOX treatments and overall increased DI would be more likely to result in higher likelihood of high‐grade neutropenic episodes and necessary treatment delays, which has been found to correlate with improved patient outcome. Using a neutrophil count of 1500 cells/μL and above to permit chemotherapy administration was described by Fournier et al as a clinically appropriate cut‐off that would permit the most condensed length of each overall treatment in each protocol, and thus, provide the highest potential DI. Furthermore, it is generally believed that anthracyclines are the most efficacious component of CHOP protocols and we felt that the increased DI of DOX in our CHOP12 would offset any diminished efficacy associated with the lower VCR DI.…”

Section: Discussionmentioning

confidence: 99%

“…Patients treated with this protocol have benefitted from similar survival times as the 25‐week CHOP protocol (CHOP25), and the shortened course of treatment may be more feasible for pet owners because of decreased temporal commitment . In addition, the dose intensity (DI) of the chemotherapy drugs in CHOP19 compared to the CHOP25 may provide further benefit by challenging neoplastic cells with various chemotherapeutics sooner and more frequently, theoretically decreasing the time for development and replication of chemotherapy‐resistant populations …”

Section: Introductionmentioning

confidence: 99%

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A comparison of 12‐ and 19‐week CHOP protocols using non‐randomized, contemporaneous controls

Vos

Pellin

Vail

2019

Vet Comparative Oncology

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This study is a concurrent comparison of two versions of CHOP protocols, a 19‐week CHOP and a comparatively overall dose‐intense 12‐week CHOP. The 12‐week protocol was designed to be 58% more dose intense than the 19‐week protocol for both doxorubicin and cyclophosphamide; however, it was 21% less dose intense for vincristine (VCR). Forty‐seven dogs were included for evaluation, and the characteristics of each population were similar. For dogs receiving the 19‐week CHOP protocol, 89.5% experienced a complete response, with a median progression‐free survival (PFS) of 245 days and median overall survival (OS) of 347 days. For dogs receiving the 12‐week CHOP protocol, 89.3% experienced a complete response, with a median PFS of 141 days and median OS of 229 days. When evaluated by Log‐rank analysis, the difference of PFS (P = 0.047) and OS (P = 0.013) between the groups were statistically significant. In summary, these data suggest that despite overall increased dose‐intensity, dogs receiving treatment with a 12‐week CHOP protocol experience less durable remission than our standard 19‐week protocol in this population. Additional prospective investigation will be required to explore the implication that VCR dose intensity and/or shorter overall temporal drug exposure in this protocol may result in diminished efficacy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A comparison of 12‐ and 19‐week CHOP protocols using non‐randomized, contemporaneous controls

Vos

Pellin

Vail

2019

Vet Comparative Oncology

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“…In 1 study in which dogs with lymphoma were treated with multidrug chemotherapy and half‐body irradiation, development of grade III or IV neutropenia was positively associated with remission duration, but RDI was not associated with outcome . In another study, dogs experiencing neutropenia during the first 9 weeks of CHOP‐based treatment had prolonged first remission duration . Notably, 76.9% of the neutropenia episodes in this study were grade I …”

Section: Discussionmentioning

confidence: 54%

“…In another study, dogs experiencing neutropenia during the first 9 weeks of CHOP‐based treatment had prolonged first remission duration . Notably, 76.9% of the neutropenia episodes in this study were grade I …”

Section: Discussionmentioning

confidence: 55%

“…In non‐Hodgkin's lymphoma in humans, a decrease in chemotherapy relative dose intensity (RDI) has been associated with poorer outcome . In dogs with lymphoma treated with a multidrug chemotherapy protocol, several studies suggested chemotherapy‐induced neutropenia prolonged first remission duration . It remains unclear, however, if RDI is directly associated with outcome in these dogs .…”

mentioning

confidence: 99%

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Impact of Pretreatment Neutrophil Count on Chemotherapy Administration and Toxicity in Dogs with Lymphoma Treated with CHOP Chemotherapy

Fournier

Serra

Handel

et al. 2017

Veterinary Internal Medicne

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BackgroundPrechemotherapy 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.ObjectivesTo 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.AnimalsDogs diagnosed with lymphoma treated with CHOP chemotherapy (n = 64).MethodsSix 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.ResultsChemotherapy 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 ImportanceThe 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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Biodynamic signatures from ex vivo bone marrow aspirates are associated with chemotherapy‐induced neutropenia in cancer‐bearing dogs

Marcum

Turek

et al. 2020

Veterinary Medicine & Sci

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Chemotherapy-induced neutropenia is associated with prolonged remission duration and survival time in canine lymphoma

Cited by 30 publications

References 26 publications

A comparison of 12‐ and 19‐week CHOP protocols using non‐randomized, contemporaneous controls

A comparison of 12‐ and 19‐week CHOP protocols using non‐randomized, contemporaneous controls

Impact of Pretreatment Neutrophil Count on Chemotherapy Administration and Toxicity in Dogs with Lymphoma Treated with CHOP Chemotherapy

Biodynamic signatures from ex vivo bone marrow aspirates are associated with chemotherapy‐induced neutropenia in cancer‐bearing dogs

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