Cyclophosphamide rescue therapy for relapsed low-grade alimentary lymphoma after chlorambucil treatment in cats

Abstract

Objectives The aims of this study were to evaluate the response, outcome and prognostic factors in cats with clinically presumed relapsed low-grade alimentary lymphoma (LGAL) receiving cyclophosphamide as a first-line rescue therapy after failing chlorambucil treatment. Methods The medical records of 20 cats (from three institutions, between 2002 and 2017) treated with cyclophosphamide for relapsed LGAL after initial treatment with chlorambucil were retrospectively reviewed. Progression-free survival (PFS), overall survival time (OST) and the association of select variables with measures of outcome were assessed. Adverse events (AEs) were also described. Results Eighteen cats (90%) achieved a complete clinical response (CR) for a median duration of 239 days. The median PFS was 215 days. The median OST was 1065 days. The only clinical factor associated with a longer PFS was achievement of a CR with cyclophosphamide treatment. Cyclophosphamide was associated with few and reversible constitutional, gastrointestinal and hematologic AEs. Conclusions and relevance Cyclophosphamide appears to be a safe and effective first-rescue therapeutic option for cats with relapsed LGAL.

Outcome and Prognostic Factors in Cats Undergoing Resection of Intestinal Adenocarcinomas: 58 Cases (2008–2020)

“…Disease progression was considered to have occurred in cats with recurrence of clinical signs whether or not repeat imaging was available. This method of reporting is commonly seen in feline intestinal tumor literature ( 22 – 24 ), although this method may have overrepresented the number of cats with progressive disease in the current study. The authors elected to not perform a multivariate analysis due to the limited number of cats with complete data sets, which could have resulted in a model with unreliable conclusions and a lack of generalizability.…”

Use of oral chemotherapeutic agent, chlorambucil, as palliative treatment of thryoid adenocarcinoma in a golden‐headed lion tamarin (Leontopithecus chrysomelas)

“…This oral chemotherapeutic agent prevents the DNA strands in cancerous cells from separating, thereby inhibiting the formation of new neoplastic cells. 10,11 It can be formulated into an oral suspension with flavoring, making it more palatable and easier to administer. Animal care staff wore gloves while handling this drug and disposed empty syringes in a secure, biohazard container.…”

“…Whole blood samples were collected to monitor hematological and biochemical values as the most common abnormalities were neutropenia, thrombocytopenia, and liver enzyme imbalances. 10,11 Thyroid hormone levels were measured with a commercial serum quantitative canine assay instead of a human assay, which has not yet been F I G U R E 2 (A) An encapsulated, moderately cellular neoplasm composed of neoplastic round to polygonal cells that form variably sized tubules and often palisade along the abundant fibrovascular stroma. Neoplastic cells have distinct cell borders and a moderate amount of eosinophilic cytoplasm (white asterisk).…”

“…Chlorambucil was chosen for this case as overall care and management logistics would have been difficult with radiation therapy. This oral chemotherapeutic agent prevents the DNA strands in cancerous cells from separating, thereby inhibiting the formation of new neoplastic cells 10,11 . It can be formulated into an oral suspension with flavoring, making it more palatable and easier to administer.…”

“…Clinical side effects of chlorambucil in domestic cats include decreased appetite, lethargy, fur loss, diarrhea, and tremors. Whole blood samples were collected to monitor hematological and biochemical values as the most common abnormalities were neutropenia, thrombocytopenia, and liver enzyme imbalances 10,11 . Thyroid hormone levels were measured with a commercial serum quantitative canine assay instead of a human assay, which has not yet been validated in this species.…”