L-Asparaginase, Doxorubicin, Vincristine, and Prednisolone (LHOP) Chemotherapy as a First-Line Treatment for Dogs with Multicentric Lymphoma

Abstract

Cyclophosphamide exhibits the weakest therapeutic effect compared with vincristine and doxorubicin in the CHOP (C, cyclophosphamide; H, doxorubicin; O, vincristine; and P, prednisolone) chemotherapeutic protocol for the treatment of canine lymphoma. Twenty dogs with multicentric lymphoma were treated using the LHOP protocol, which used l-asparaginase in place of cyclophosphamide, and the outcomes were historically compared with those of dogs that received CHOP chemotherapy in the same institution. No significant differences were found in age (p = 0.107), body weight (p = 0.051), sex (p = 0.453), clinical stage V (p = 1), substage b (p = 0.573), T-cell phenotype (p = 0.340), overall response (p = 1), and hypercalcaemia status (p = 1) between the LHOP and CHOP groups. The adverse effects of l-asparaginase were well tolerated and self-limiting. The median PFS (progression-free survival) and median ST (survival time) in the LHOP group were 344 days (range: 28–940 days) and 344 days (range: 70–940 days), respectively. The median PFS and median ST in the CHOP group were 234 days (range: 49–1822 days) and 314 days (range: 50–1822 days), respectively. The dogs that received LHOP chemotherapy had a significantly longer PFS than the dogs that received CHOP chemotherapy (p = 0.001). No significant difference was observed in ST between the LHOP and CHOP groups (p = 0.131). Our study findings thus indicate that the LHOP protocol can be used as a first-line chemotherapeutic protocol in canine multicentric lymphoma.

Review of Canine Lymphoma Treated with Chemotherapy—Outcomes and Prognostic Factors

“…The outcome for multicentric or generalised nodal lymphoma treated with a CHOP-like protocol was reported in 43 papers with 54 groups and 4382 cases [ 5 , 12 , 13 , 15 , 22 , 38 , 40 , 43 , 55 , 56 , 58 , 64 , 76 , 83 , 85 , 88 , 90 , 92 , 95 , 97 , 98 , 99 , 100 , 102 , 107 , 110 , 111 , 112 , 113 , 118 , 120 , 123 , 124 , 126 , 132 , 134 , 136 , 166 , 168 , 169 , 172 , 174 , 175 ]. Nine papers included only dogs with B-cell lymphoma [ 12 , 13 , 15 , 55 , 56 , 76 , 88 , 102 , 124 ], three included only T-cell lymphoma [ ...…”

Hematological and blood biochemistry parameters as prognostic indicators of survival in canine multicentric lymphoma treated with COP and L-COP protocols

“…Considering the effect of the L-COP protocol on kidney function, while cyclophosphamide has mostly been reported to be related to hemorrhagic cystitis [ 39 ], few studies have reported drug-related nephrotoxicity of cyclophosphamide [ 40 , 41 ]. Although limited information is available, L-asparaginase and vincristine have direct effects on kidney function [ 42 , 43 ]. In contrast, prednisolone has anti-inflammatory effects that improve kidney function and hemodynamic stability [ 44 , 45 ].…”

Increased plasma DR‐70 (fibrinogen‐fibrin degradation products) concentrations as a diagnostic biomarker in dogs with neoplasms

“…Of these patient dogs, cases with ≥2 types of tumors and medical records with limited information were categorized as the “other” group. For dogs with lymphoma, the immunophenotype was determined by flow cytometry or immunohistochemistry 23 . Mast cell tumors (MCTs) were categorized by recorded grade according to the clinical staging system proposed by the World Health Organization (WHO) 24 .…”

“…For dogs with lymphoma, the immunophenotype was determined by flow cytometry or immunohistochemistry. 23 Mast cell tumors (MCTs) were categorized by recorded grade according to the clinical staging system proposed by the World Health Organization (WHO). 24 Dogs with regional or systemic metastasis were classified as stage II or above.…”