Outcome and toxicity associated with a dose-intensified, maintenance-free CHOP-based chemotherapy protocol in canine lymphoma: 130 cases

Abstract

A dose-intensified/dose-dense chemotherapy protocol for canine lymphoma was designed and implemented at the Veterinary Hospital of the University of Pennsylvania. In this study, we describe the clinical characteristics, prognostic factors, efficacy and toxicity in 130 dogs treated with this protocol. The majority of the dogs had advanced stage disease (63.1% stage V) and sub-stage b (58.5%). The median time to progression (TTP) and lymphoma-specific survival were 219 and 323 days, respectively. These results are similar to previous less dose-intense protocols. Sub-stage was a significant negative prognostic factor for survival. The incidence of toxicity was high; 53.9 and 45% of the dogs needed dose reductions and treatment delays, respectively. Dogs that required dose reductions and treatment delays had significantly longer TTP and lymphoma-specific survival times. These results suggest that dose density is important, but likely relative, and needs to be adjusted according to the individual patient's toxicity for optimal outcome.

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

“…This result is similar to studies involving doseintensified chemotherapy that investigated canine lymphoma (Vaughan et al, 2007;Sorenmo et al, 2010). One recent report revealed that dogs that needed dose reductions and treatment delays after chemoradiotherapy had longer remission durations.…”

“…Based on our research, only three reports have indicated increased remission duration or survival time (ST) in dogs with lymphoma that required dose reduction and treatment delays after being treated with chemoradiotherapy or dose-intensified chemotherapy protocols (Vaughan et al, 2007;Sorenmo et al, 2010;Burton et al, 2013). However, no studies have investigated the effects of chemotherapyinduced neutropenia in dogs with lymphoma treated with conventional dosages of chemotherapy.…”

Tolerability of a rapid‐escalation vinblastine‐prednisolone protocol in dogs with mast cell tumours

“…In canine lymphoma, dogs which developed grade 3 or 4 neutropenia following chemotherapy demonstrated improved outcomes, raising the possibility that more appropriate individual dosing was administered (Sorenmo et al . 2010; Vaughan et al . 2007).…”

Increase in Minimal Residual Disease in Peripheral Blood before Clinical Relapse in Dogs with Lymphoma that Achieved Complete Remission after Chemotherapy

“…Despite the fact that various multidrug chemotherapeutic protocols have been introduced, the median survival time in a recent study was approximately 12 months. 5 In general, the treatment of relapsed lymphoma results in a lower response rate and shorter remission duration compared with untreated lymphoma. [6][7][8] Early detection of tumor relapse and prompt therapy are a reasonable approach for managing recrudescent disease.…”