Find comprehensive guides on various chemotherapy protocols.
The CHOP chemotherapy protocol continues to be the treatment option that provides the longest median duration of remission and survival for dogs with multicentric high-grade lymphoma, with 80-90% of dogs achieving remission. As the ability to refine the diagnosis of lymphoma continues to improve (e.g. through the use of flow cytometry and polymerase chain reaction to detect antigen receptor rearrangement, as well as increasing numbers of immuno-cyto and -histochemical stains), we are learning more about the myriad forms of canine lymphoma with varying biologic behavior and response to therapy. The UWVC Oncology Service is happy to consult with veterinarians about canine lymphoma, whether you are managing a routine high-grade lymphoma or a different form of the disease.
CHOP Protocol – Feline
Combination chemotherapy is the treatment option that provides the longest median duration of remission and survival for cats with high-grade lymphoma. Unlike dogs, cats with lymphoma do not have as robust of a response to chemotherapy. Approximately 38% of patients will have a complete response, with another 25% having a partial remission. Because response to therapy is a prognostic factor, those cats having a better response to CHOP live longer. Although reported median progression free and overall survival times are 56 and 97 days, respectively, a subset of cats will have prolonged survival times of >1500 days. The UWVC Oncology Service is happy to consult with veterinarians about feline lymphoma, whether you are managing a patient with high-grade lymphoma or a different form of the disease.
Canine Lymphoma Rescue protocol
This rescue chemotherapy protocol is what UW Oncology turns to when a canine patient with high-grade lymphoma has relapsed less than 3 months after completing the CHOP protocol. This protocol may also be used as the first chemotherapy treatment option in situations where the CHOP protocol is not a viable option for the patient or the client. Because CCNU is hepatotoxic, patients on this protocol need to be on a hepato-protective agent such as Denamarin for the duration of the protocol and liver enzymes (at a minimum ALT and ALP) should be monitored along with a CBC prior to each CCNU dose. The UWVC Oncology Service is happy to consult with veterinarians about canine lymphoma, whether you are managing a routine high-grade lymphoma or a different form of the disease.
Single Agent Doxorubicin protocol
Doxorubicin is a broad spectrum chemotherapeutic agent used to treat a wide variety of cancers in dogs and cats. It has activity against lymphoma, carcinomas and sarcomas and is a less expensive option than some combination protocols, as well as some of the newer anti-cancer treatment options. When administering doxorubicin, it is essential that the patient have a cleanly placed intravenous catheter that flushes easily. For personnel safety, we always recommend using a closed-system for chemotherapy administration (e.g. Equashield or PhaSeal). Doxorubicin is a severe tissue vesicant and extravasation of this drug will result in significant, potentially life-threatening tissue damage. Doxorubicin is cardiotoxic, with a small percentage of dogs experiencing arrhythmias during drug administration as well as the risk of inducing a dilated-type cardiomyopathy after a cumulative dose of 150-180 mg/m2. Doxorubicin may also cause an allergic-type reaction during administration. Watch for urticaria or pruritis, typically around the face and ears, as well as for GI signs of allergic reaction during administration including flatulence, diarrhea or defecation, drooling or vomiting. If allergic type reactions are noted during administration, stop giving the doxorubicin and treat the patient with species-appropriate doses of diphenhydramine and anti-inflammatory doses of steroids. As the reaction subsides, the doxorubicin treatment may be completed at a slower rate. For future doses, pre-treatment with diphenhydramine and steroids is recommended. The UWVC Oncology Service is happy to consult with veterinarians about chemotherapy protocol choices and administration.