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. 2024 Jul-Aug;38(4):2282-2292.
doi: 10.1111/jvim.17139. Epub 2024 Jul 3.

Early progression during or after cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy indicates poor outcome with rescue protocols in dogs with multicentric lymphoma

Ashley S Parker  1 , Jenna H Burton  1 , Kaitlin M Curran  2 , Amber Wolf-Ringwall  3 , Douglas H Thamm  1
Affiliations

Early progression during or after cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy indicates poor outcome with rescue protocols in dogs with multicentric lymphoma

Ashley S Parker et al. J Vet Intern Med. 2024 Jul-Aug.

Abstract

Background: Dogs with lymphoma that fail cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy (CHOP) before completion of their protocol are commonly thought to have poor long-term outcome, but no previous studies have evaluated the effect of early relapse on progression-free interval (PFI) or overall survival time (OST) for patients undergoing rescue chemotherapy.

Objective: Correlate rescue treatment outcomes in dogs with multicentric lymphoma with outcomes after 1st-line CHOP chemotherapy.

Methods: Data were collected from 6 previous retrospective or prospective studies in 187 dogs with multicentric lymphoma that received 1st-line CHOP chemotherapy and then received either lomustine (CCNU), L-asparaginase and prednisone (LAP), or rabacfosadine (RAB, Tanovea), with or without prednisone or L-asparaginase.

Results: The PFI after initiation of CHOP chemotherapy was significantly associated with response rate postprogression, PFI, and postrescue survival time (ST) for both rescue protocols. Immunophenotype (B- vs T-cell) was not significantly associated with response, PFI or OST for LAP but was significantly associated with response and PFI for RAB.

Conclusion: Dogs that experience short PFI during or after 1st-line CHOP chemotherapy had lower response rates to rescue treatment, with shorter PFI and ST. Immunophenotype did not significantly affect outcome with LAP but was associated with PFI for RAB.

Keywords: canine; hematopoietic; multicentric; remission; species.

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Conflict of interest statement

Douglas H. Thamm is an advisor for and shareholder in VetDC, Inc. and a paid consultant for Elanco Animal Health. No other authors declare a conflict of interest.

Figures

FIGURE 1
FIGURE 1
Kaplan‐Meier curve depicting effects of initial cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) treatment progression‐free interval (PFI) on rescue PFI after lomustine, L‐asparaginase, and prednisone (LAP) (top left) and rabacfosadine (RAB) (top right) rescue treatment. Kaplan‐Meier curves depicting effects of initial treatment PFI on postrescue treatment survival time (PRST) after LAP (bottom left) and RAB (bottom right) rescue treatment. P‐values represent univariate log rank values. Tick marks indicate censored patients. HR, hazard ratio.
FIGURE 2
FIGURE 2
Stacked bar graph depicting effects of initial cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) treatment progression‐free interval (PFI) on overall response rate (ORR) and complete response (CR) rate to lomustine, L‐asparaginase, and prednisone (LAP) (left) and rabacfosadine (RAB) (right) rescue protocols. Partial response (PR) and no response (NR). HR, hazard ratio.
FIGURE 3
FIGURE 3
Kaplan‐Meier curves depicting effects of lymphoma immunophenotype (B‐ vs T‐cell) on progression‐free interval (PFI) for dogs undergoing either lomustine, L‐asparaginase, and prednisone (LAP) (left) or rabacfosadine (RAB) (right) rescue protocols. P‐values represent univariate log rank values. Tick marks indicate censored patients. HR, hazard ratio.
See this image and copyright information in PMC

References

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