Epirubicin as part of a multi‐agent chemotherapy protocol for canine lymphoma

Elliott, James; Cripps, Peter; Marrington, A. M.; Grant, Iain; Blackwood, Laura

doi:10.1111/j.1476-5829.2011.00311.x

Cited by 31 publications

(43 citation statements)

References 62 publications

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“…There were 19 intact males (M), 41 neutered males (MN), 6 intact females (F) and 34 neutered females (FN). The most commonly affected pure breeds included Boxers, Border Collies, and Bullmastiffs …”

Section: Resultsmentioning

confidence: 99%

“…High‐grade T‐cell lymphomas are less common and though response rates and duration are shorter, treatment is similar . The overall response rate for CHOP/CEOP protocols is between 89% and 100%, and the median first remission duration is 142 to 302 days . Median first remission duration for T‐cell cNHL is shorter than 5 months, compared with 11 months for B‐cell cNHL …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Smallwood

Tanis

Grant

et al. 2019

Vet Comparative Oncology

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The DMAC protocol (dexamethasone, melphalan, actinomycin‐D, cytarabine) has been evaluated in American studies for the treatment of relapsed canine lymphoma, comparing similarly to other rescue protocols. The aim of this study was to evaluate efficacy and toxicity of DMAC, in a larger UK cohort of resistant canine lymphomas. Medical records of dogs with resistant non‐Hodgkin high‐grade lymphomas that received DMAC as a rescue protocol were reviewed from 2007 to 2017. Response, time from initiation to discontinuation (TTD) and toxicity (Veterinary Cooperative Oncology Group criteria) were assessed. One hundred dogs were included; 86 received CEOP (modified CHOP including epirubicin) as first‐line treatment. Thirty‐five dogs (35%) responded: 21 complete responders (CRs) and 14 partial responders (PRs). Responders had significantly longer TTD (P < 0.001) compared with non‐responders: 62 days (range 28‐952) for CR vs 32 days (range 20‐70) for PR. Six CR received more than six cycles of DMAC (range 7‐36 cycles) and experienced a longer TTD (median 508, range 126‐952 days). Thrombocytopenia occurred in 45% (24 grade 1‐2, 21 grade 3‐4) and neutropenia in 36% of cases (29 grade 1‐2, 7 grade 3‐4). Gastrointestinal toxicity occurred in 42% of dogs (40 grade 1‐2, 2 grade 3‐4). Owing to chemotherapy toxicity, treatment was discontinued in five, and hospitalization required in six cases. In this study, response to DMAC was lower and of generally shorter duration than previously reported. Toxicity was high, but infrequently led to hospitalization or discontinuation of treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Smallwood

Tanis

Grant

et al. 2019

Vet Comparative Oncology

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“…For this retrospective case series, the computerised clinical records database of the hospital was searched for patients that had received cytarabine as a CRI between 2012–2017. Dogs were included if: (1) they had a cytological or histopathological diagnosis of high‐grade cNHL, (2) cytarabine CRI was included as part of the first‐line CEOP chemotherapy protocol to treat naive dogs and (3) pre‐ and post‐treatment haematology results were available.…”

Section: Methodsmentioning

confidence: 99%

“…Haematopoietic neoplasias are common in dogs, with canine non‐Hodgkin lymphomas (cNHLs) comprising over 80% of all haematopoietic cancers . Among cNHLs, high‐grade B‐cell lymphomas prevail and first‐line chemotherapy consists of maintenance‐free protocols, including prednisolone, vincristine, cyclophosphamide and doxorubicin (CHOP); variants replacing doxorubicin with epirubicin (cyclophosphamide, epirubicin, vincristine and prednisolone [CEOP]) show similar results . High‐grade T‐cell lymphomas are less common and are associated with lower response rates and shorter remission rates when using CHOP‐based protocols …”

mentioning

confidence: 99%

Toxicity of cytarabine constant rate infusion in dogs with high‐grade non‐Hodgkin lymphoma with bone marrow or central nervous system involvement

et al. 2019

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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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“…Illustrations of survival times are provided however readers unfamiliar with oncology are advised that these provide specific examples and do not represent the entirety of the field. Chemotherapy has been shown to extend the lifespan of terminally ill dogs diagnosed with malignant neoplasia on average by 185 days (histiocytic sarcoma) [22], 301 days (appendicular osteosarcoma) [23] and 216 to 342 days (lymphoma) [24]. Similar results have been found in cats that have undergone chemotherapy for extranodal lymphoma recording survival times ranging from 70 days to 749 days [25].…”

Section: Introductionmentioning

confidence: 62%

Factors Which Influence Owners When Deciding to Use Chemotherapy in Terminally Ill Pets

Williams

Phillips

Byrd

2017

Animals

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Simple SummaryCancer is as common amongst pets as it in humans. Chemotherapy can be integrated into treatment regimes for terminally ill pets to attempt to shrink tumours to extend life expectancy, but it does not cure cancer and it can have negative side effects including vomiting, depression and behavioral changes. To date, little research has been undertaken to explore owners’ decisions whether or not to treat their animals with chemotherapy. Seventy-eight dog and cat owners completed an online questionnaire to determine if they would opt for chemotherapy if their pet was diagnosed with cancer, and asked how they thought their pet’s quality of life would be affected. Fifty-eight percent of respondents would not use chemotherapy largely due to their previous experience of it. Seventy-two percent over estimated pet survival time post chemotherapy, with most people believing it would lead to remission or a cure. Owners expected their pets to be less active, sleep more and play less, reducing their quality of life. Common side effects associated with chemotherapy were not rated as acceptable. The results suggest pet owners would benefit from an increased understanding of the positive and negative impacts of chemotherapy when initially discussing treatment options with the veterinary team.AbstractChemotherapy is a commonly integrated treatment option within human and animal oncology regimes. Limited research has investigated pet owners’ treatment decision-making in animals diagnosed with malignant neoplasia. Dog and cat owners were asked to complete an online questionnaire to elucidate factors which are key to the decision making process. Seventy-eight respondents completed the questionnaire in full. Fifty-eight percent of pet owners would not elect to treat pets with chemotherapy due to the negative impact of the associated side effects. Seventy-two percent of respondents over estimated pet survival time post chemotherapy, indicating a general perception that it would lead to remission or a cure. Vomiting was considered an acceptable side effect but inappetence, weight loss and depression were considered unacceptable. Owners did expect animals’ to be less active, sleep more and play less, but common side effects were not rated as acceptable despite the potential benefits of chemotherapy. Based on the results, veterinary teams involved with oncology consultations should establish if clients have prior experience of cancer treatments and their expectations of survival time. Quality of life assessments should also be implemented during initial oncology consultations and conducted regularly during chemotherapy courses to inform client decision making and to safe guard animal welfare.

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Epirubicin as part of a multi‐agent chemotherapy protocol for canine lymphoma

Cited by 31 publications

References 62 publications

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

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

Toxicity of cytarabine constant rate infusion in dogs with high‐grade non‐Hodgkin lymphoma with bone marrow or central nervous system involvement

Factors Which Influence Owners When Deciding to Use Chemotherapy in Terminally Ill Pets

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