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

Abstract

Background and aim: Hematological and blood chemistry parameters are crucial for evaluating and monitoring canine multicentric lymphoma during chemotherapy. Pre-treatment hematological and blood chemistry parameters can be used as prognostic survival outcomes for this disease. Therefore, this study aimed to investigate the effect of hematological and blood chemistry parameters pre-treatment and 4 weeks post-treatment on the survival outcomes of dogs treated with either a combination of cyclophosphamide, vincristine, and prednisolone (COP) or a combination of COP with L-asparaginase (L-COP) protocols.

Materials and methods: We conducted a retrospective study. Medical records and hematological and blood chemistry parameters of 41 dogs with multicentric lymphoma treated with L-COP (n = 26) and the COP protocols (n = 15) were obtained from the hospital information system. Most cases were classified as high-grade lymphoma based on the Kiel cytological classification. The effects of hematological and blood chemistry parameters on survival outcomes were investigated using the Cox proportional hazard regression model. The median survival time (MST) for each hematological and blood chemistry parameter affecting survival outcome was established and compared using the Kaplan-Meier product limit method with the log-rank test.

Results: Dogs with high-grade multicentric lymphoma that were treated with the COP protocol and had monocytosis at pre-treatment had a significantly shorter MST than dogs with normal monocyte counts (p = 0.033). In addition, dogs with azotemia, both pre-treatment and 4 weeks post-treatment, had a significantly shorter MST than dogs with normal serum creatinine levels (p = 0.012). Dogs with high-grade multicentric lymphoma treated with the L-COP protocol who had hypoalbuminemia (serum albumin concentration <2.5 mg/dL) at both pre-treatment and 4 weeks post-treatment had a significantly shorter MST than dogs with normal serum albumin levels (p < 0.001). Furthermore, dogs with leukocytosis at 4 weeks post-treatment had a significantly shorter MST than those with a normal total white blood cell count (p = 0.024).

Conclusion: Serum albumin level can serve as a simple negative prognostic indicator of survival outcomes in dogs with high-grade multicentric lymphoma treated with the L-COP protocol. Dogs with hypoalbuminemia pre-treatment and 4 weeks post-treatment tended to have a shorter MST than those with normal serum albumin concentrations.

Keywords: anti-cancer; chemotherapy; dogs; hypoalbuminemia; multicentric lymphoma; prognosis; retrospective study; survival outcomes.

Figure-1

Kaplan–Meier curve represents median survival time of dogs with monocytosis at pre-treatment and those with normal monocyte count that were treated with cyclophosphamide, vincristine, and prednisolone protocol were 51 days and 388 days, respectively, at p = 0.033.

Figure-2

Kaplan–Meier curve represents median survival time of dogs with high creatinine concentration at pre-treatment and those with normal creatinine concentration that were treated with cyclophosphamide, vincristine, and prednisolone protocol were 51 days and 208 days, respectively, at p = 0.012.

Figure-3

Kaplan–Meier curve represents median survival time of dogs with hypoalbuminemia and dogs with normal serum albumin concentration that was treated with cyclophosphamide, vincristine, and prednisolone with L-asparaginase protocol were 64 days and 249 days, respectively, at p < 0.001.

Figure-4

Kaplan–Meier curve represents the median survival time of dogs with leukocytosis and those with normal white blood cell count that were treated with cyclophosphamide, vincristine, and prednisolone with L-asparaginase protocol were 71 days and 249 days, respectively, at p = 0.024. TWBC=Total white blood cells.