Thirteen-week dose-intensifying simultaneous combination chemotherapy protocol for malignant lymphoma in dogs

• Published in: Veterinary record Vol. 167; no. 19; pp. 744 - 748
• Main Authors: Zenker, I., Meichner, K., Steinle, K., Kessler, M., Hirschberger, J.
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Limited 06.11.2010; Blackwell Publishing Ltd
• Subjects: adverse effects; Animals; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; asparaginase; Asparaginase - administration & dosage; Asparaginase - therapeutic use; Bone marrow; cell biology; Cellular biology; Chemotherapy; combination drug therapy; Consent; Cyclophosphamide - administration & dosage; Cyclophosphamide - therapeutic use; disease course; disease diagnosis; dog diseases; Dog Diseases - drug therapy; Dog Diseases - pathology; Dogs; dosage; dose response; dose-intensifying simultaneous chemotherapy; Dose-Response Relationship, Drug; Doxorubicin - administration & dosage; Doxorubicin - therapeutic use; Drug dosages; Drug resistance; Female; histopathology; intramuscular injection; Lymphoma; Lymphoma - drug therapy; Lymphoma - pathology; Lymphoma - veterinary; Male; malignant lymphoma; Neoplasm Staging - veterinary; Prospective Studies; Remission Induction; Studies; subcutaneous injection; toxicity; Treatment Outcome; Tumors; Veterinary medicine; vincristine; Vincristine - administration & dosage; Vincristine - therapeutic use
• ISSN: 0042-4900; 2042-7670
• DOI: 10.1136/vr.c5081

This prospective study aimed to record the toxicity profile of a dose-intensifying simultaneous chemotherapy (DISC) protocol for lymphoma in dogs. Remission rates and the duration of the protocol were also evaluated. Twenty-one dogs were studied. Diagnosis was based on cytological or histological assessments. The DISC protocol is a 13-week maintenance-free protocol. L-Asparaginase (400 iu/kg) was administered subcutaneously on day 1, followed by weekly simultaneous intravenous administration of vincristine (0.7 mg/m2 = 100 per cent), cyclophosphamide (200 mg/m2 = 100 per cent) and doxorubicin (30 mg/m2 = 100 per cent) at a starting dose level of 33 per cent. Dose levels were given twice and then increased by 5 to 7 per cent if grade 0 or I toxicities were seen, to a maximum dose level of 60 per cent. Two dogs experienced a grade IV toxicity (asymptomatic neutropenia in one dog and sepsis in the other). Two episodes of asymptomatic grade III thrombocytopenia and one episode of neutropenia were recorded. Other toxic events were infrequent and mild. Only one dog required hospitalisation for less than 72 hours. Seventeen dogs (80.9 per cent) achieved complete remission, one (4.8 per cent) achieved partial remission, two (9.5 per cent) had stable disease and in one (4.8 per cent) disease progressed.