18: Lymphoma 2 Flashcards
How long do lymphoma patients survive with no treatment?
6-8 weeks
How long do lymphoma patients treated with preds only survive?
2-3 months
How long do lymphoma patients treated with chemo survive?
6-18 months
How often can you cure lymphoma in animals?
Rarely
Why should you not give steroids AND chemotherapy?
Drug resistance and makes diagnosis hard
What does COPA/CHOP have that COP doesn’t?
Doxorubicin
What does LLCAP-UW-Madison contain that COP/COPA/CHOP don’t?
L-Asparaginase
What are the two kinds of COP protocols?
Low-dose/continuous or high-dose/pulse
Which COP component do cats tolerate well?
Cyclophosphamide
How myelosuppressive is COP?
Not very
How many blood tests does COP need?
Not many
Is a high or low dose COP better for cats?
High
How long should you do high-dose COP for in cats?
6 months only
What are some cyclic combination protocols?
VLCAP/UW-Madison/CHOP
What kind of lymphoma is VLCAP/UW-Madison/CHOP especially good for?
B cell lymphoma
Which protocols resemble high dose COP and doxorubicin?
VLCAP/UW-Madison/CHOP
What % of dogs achieve remission?
70-80%
What is median remission?
3-12 months
What is median survival?
6-18 months of normal healthy life
What is evidence for short 12 week treatment then only treating again during relapse?
Some evidence
When should you only use asparaginase?
Rescue
What is the prognosis in cats if response to chemo is good?
Good
Which cat breed has a good prognosis?
Siamese
Which kind of lymphoma is aggressive with only a short-lived response to treatment?
Primary cutaenous
Which kind of lymphoma shows a poor response to treatment but slow progression?
Epitheliotropic
What is treating diffuse alimentary lymphoma like in dogs?
Unrewarding
What is treating diffuse alimentary lymphoma like in cats?
Short term response
Which kind of diffuse alimentary lymphoma can you surgically remove?
Focal disease
What are the two types of feline alimentary lymphoma?
Small or large cell
What are the characteristics of feline small cell alimentary lymphoma?
Well-differentiated, lymphocytic, low grade, T cell
Which kind of cat is feline small cell alimentary lymphoma common in?
Very common esp older male DSH
Which species response well to thymic lymphoma treatment?
Young cats
Why do dogs respond less well to thymic lymphoma?
T cell phenotype
What are the two types of lymphoid leukaemias?
Acute lymphoblastic or chronic lymphocytic
What are cells like in acute lymphoblastic leukaemia?
Malignant early stage
What are cells like in chronic lymphocytic leukaemia?
Later stage precursor
Which cells give rise to blast-forming units?
Myeloid stem cells
What phase is lost in acute leukaemia?
Maturation phase
What is increased in chronic leukaemia?
Over-production
What are the two types of acute leukaemias?
Myeloid or lymphoid
What are some complications of acute leukaemias?
BOne marrow suppression, sepsis, DIC, organ failure
What can clinical signs be like in early stages of leukaemia?
Vague
Why do you need a marrow sample in pancytopenia?
Problem lies at production
What other clinical signs should you get a bone marrow sample if seen?
Pyrexia, unexplained hyperCa, abnormal cells
Which kind of needle do you use for a bone marrow sample?
Klina
Where do you get bone marrow sample in dog?
Wing of ilium
Where do you get bone marrow sample in cat?
Shaft of femur
Why must you work fast when taking a bone marrow sample?
Will fail if clotted or diluted
Why are bone marrow samples painful?
Can block with local but can’t block endosteum
What kind of needle do you use to take a bone marrow core?
Jamshidi
How successful is chemo for leukaemia?
Not very - poor prognosis
How long is survival time with leukaemia?
Weeks
What are the three types of chronic leukaemia?
Lymphocytic, granulocytic, myeloid
What is progression and clinical signs like in chronic leukaemia?
Slow progression, mild signs
What is the only thing that will cause massive leukocytosis?
Chronic leukaemia
What is the aim of treatment for chronic leukaemia?
Restore blood count to normal - long term maintenance
What is the prognosis like for chronic leukaemia?
Good - 12-18 months+
What can be a complication of CML?
Can transform to a blast cell crisis
What is another name for a plasma cell myeloma?
Multiple myeloma
How do cats with multiple myeloma present?
Neutropenia, anaemia, thrombocytopenia, bague signs, hyperviscosity syndromes, skeletal pain
What does bone marrow look like in multiple myeloma?
Plasma cells in sheets and clusters
How do you treat multiple myeloma?
Alkylating agents, steroids +/- vincristine
What is usual response to treatment to multiple myeloma?
Good - median survivial 12-18 months
