Hematopoietic Tumors Flashcards
What was the overall MST in dogs w/ untreated, peripheral intermediate-large cell LSA treated with prednisone alone?
50 days
____ and ____ were associated with survival time in dogs with untreated, peripheral intermediate - large cell LSA treated w/ prednisone alone.
Owner-perceived QOL scores and substage
What was the PFS and ORR for naive & previously treated dogs with MC lymphoma treated with Tanovea? What was the PFS in placebo treated dogs?
Tanovea PFS was significantly longer than placebo (~3 months vs. 21 days)
ORR: 73% (CR 51%)
What was the ORR and PFS in naive dogs w/ MC LSA treated with Tanovea +/- steroids (Thamm paper)?
ORR: 87% (CR 52%)
PFS: 4 months
In a retrospective study evaluating the diagnostic relevance of lymph node biopsy in cats with small cell intestinal lymphoma, ___% showed no nodal involvement.
70%
In a retrospective study evaluating the diagnostic relevance of lymph node biopsy in cats with small cell intestinal lymphoma, ___% of clonality tests correctly identified reactive lymph nodes.
63%
In a prospective clinical trial of dogs with diffuse, naive large B cell LSA treated with low dose doxorubicin and anti-CD20 monoclonal antibody (1E4-cIgGB), a significant depletion in ______ cells was seen 7 days post infusion. This depletion persisted for ____ months.
CD21+ B cells; 4+ months
A retrospective study evaluating vincristine-induced side effects related to body weight in dogs treated for LSA found that vincristine dosed at 0.6mg/m2 ______ the risk of hematologic events in dogs weighing <15kg.
Does not increase
A retrospective study evaluating vincristine-induced side effects related to body weight in dogs treated for LSA found that dogs treated with median dose of 0.6mg/m2 had a __% risk of neutropenia and ___% risk of GI AEs.
12%; 29%
What was the overall MST reported in a retrospective study of 50 cats with MRD treated with various chemo protocols? What variables were associated with shorter outcomes?
MST: 4mo
Anemia & thrombocytopenia
List the overall response rates to the following chemotherapy protocols that were found in a retrospective study of 50 cats with MRD. Was the type of chemotherapy protocol significantly associated w/ survival?
a. melphalan + pred ____%
b. Cytoxan + pred ___%
c. Chlorambucil + pred ___%
a. 87%
b. 90%
c. 100%
No
Adverse events to melphalan or cyclophosphamide
occurred in ___% and __% of cats, respectively, in a retrospective study evaluating outcome in cats w/ MRD.
melphalan - 65%
Cytoxan - 23%
In a retrospective study investigating the relationship b/w serum cortisol concentrations and chemotherapy outcome in dogs with lymphoma, the high COR group experienced a ________, ______, and _______.
- significantly lower response to chemotherapy
- lower PFS
- lower MST
In a retrospective study investigating the relationship b/w serum cortisol concentrations and chemotherapy outcome in dogs with lymphoma, although no significant differences were found in rate of _____ cells b/w groups, the rate of ____ cells was significantly lower in the high COR group.
- Pgp+ cells
- Glucocorticoid receptor + cells
What was the ORR, PFS, and MST in a prospective cohort study in dogs with MC LSA that underwent dose-escalation 15-week CHOP.
ORR - 100%
PFS - 6mo
MST - 8.5mo
In a prospective cohort study for dogs with MC LSA that underwent dose-escalation 15-week CHOP, for the dogs that were able to dose escalate, at least 1 drug was successfully escalated in ____%. ____% of the dogs that underwent dose escalation were hospitalized at least once due to AEs. The most common DLT of all dogs was ______________.
- 78%
- 13%
- Neutropenia
In a prospective study of dogs with MC B cell LSA comparing those that received chemotherapy + half-body radiation to historical matched controls only receiving chemotherapy, the radiation cohort’s 2-year disease-free rate was _____% and the median remission was _____. The control group’s 2-year disease-free rate was ____% and the median remission was ____.
RT group:
- 56%
- exceeded 730-day study period
Control:
- 0%
- 9mo
In a prospective study of dogs with MC B cell LSA comparing those that received chemotherapy + half-body radiation to historical matched controls only receiving chemotherapy, the radiation cohort’s 2-year survival rate was ____% and the MST was ____. The control group’s 2-year survival rate was ___% and the MST was ____.
RT group
- 78%
- MST: exceeded 730 day study period
Control:
- 11%
- MST: 9.5mo
What was the MST reported in 11 dogs with suspected primary bone marrow T-cell lymphoid neoplasia causing hypercalcemia w/ treatments ranging from prednisone alone to multi-agent chemotherapy?
MST - 9mo
A retrospective study evaluating pegylated-l-asparaginase mono therapy in 83 cats with large cell LSA found a response rate of ____% with ___% in CR.
- RR: 74%
- CR 38%
A retrospective study evaluating pegylated-l-asparaginase mono therapy in 83 cats with large cell LSA found a median disease free period of _____ and overall survival time of _____.
- Disease free period: 70 days
- MST: 79 days
In a retrospective study evaluating CMOP as first line treatment for 31 cats with intermediate - large cell LSA, the ORR was ____%, the CR rate was ____% and the PR rate _____%.
- ORR: 74%
- CR: 45%
- PR: 29%
Retrospective evaluation of melphalan, vincristine, and cytarabine (MOC) novel multi-agent protocol in 26 dogs with relapsed multicentric LSA found an ORR ____% with ___% experiencing a CR
- ORR: 38%
- CR: 19%
Retrospective evaluation of melphalan, vincristine, and cytarabine (MOC) novel multi-agent protocol in 26 dogs with relapsed multicentric LSA found a PFS of ____ days. The overall clinical benefit was ___ with a median of ____ days. All dogs experienced side effects with majority graded as _____.
- PFS: 29 days
- clinical benefit: 65% w/ median of 37 days
- mild
Treatment of feline intermediate to high grade alimentary LSA using a novel multi-agent chemotherapy protocol (VAPC: V: Vinblastine, A: doxorubicin; P: procarbazine; C: high-dose cytoxan; Elspar, prednisolone) +/- surgery was assessed in 55 cats. Of 38 cats receiving chemotherapy for measurable disease, ___% achieved a CR. For all cats, PFS was ____ and 1-year, 2-year, and 3-year survival rates were ____%, ____% and ____%, respectively. MST for CR cats was _____. PFS was significantly affected by ______ and _____.
- CR rate: 68%
- PFS: 6mo
- 1year survival rate: 35%
- 2 & 3 year survival rates: 25%
- CR MST: 11mo
- lymphocyte:monocyte ration >3.4 increased survival and B cell immunophenotype increased survival
65 dogs with large granular lymphocyte lymphoma were evaluated. The most common breed was a _______. 32 dogs were treated with MTD chemotherapy w/ a response documented in ___%, PFI of ___, and MST of ____.
- response rate: 74%
- PFI: 17d
- MST: 28d
A retrospective study out of France evaluating feline high-grade and large granular alimentary LSA treated with COP or CHOP (n=57) found a CR rate of ___%, PR rate of ___%, SD ___%, PD ___% for an ORR of ___%. PFI was ____ and OST was ____.
- CR: 20%
- PR: 22%
- SD: 36%
- PD: 22%
- ORR: 42%
- PFI: 5mo
- OST: 4mo
A retrospective study out of Australia evaluated clinical response and prognostic factors in canine MC LSA treated w/ first rescue therapy (CHOP-like, CCNU-rich combo, Doxorubicin single-agent, CCNU single-agent). Median PFS was ____.
PFS: 56d
A prospective trial (Thamm) evaluating alternating Tanovea and doxorubicin treatment for naive canine lymphoma was recently performed in 59 dogs. ORR was ___% with CR rate of ____% and PR of ___%. PFS was _____.
- ORR: 93%
- CR: 79%
- PR: 14%
- PFS: 7mo
A retrospective study evaluating use of lomustine and prednisolone as first-line treatment for dogs with MC LSA was performed. The ORR was ___% with a CR rate of ___% and PR rate of ___%. Median TTP, DFI, and MST were ____, _____, and ____, respectively. The only factor associated w/ DFI and MST was ______.
- ORR: 87%
- CR: 50%
- PR: 37%
- TTP: 42d
- DFI: 63d
- MST: 90d
- stage
The efficacy of mirtazapine in reducing GI adverse effects was evaluated in 11 cats treated with doxorubicin in a placebo-controlled crossover study. The results demonstrated that mirtazapine can significantly increase _______, ______, and _______ and reduce ______ in cats after receiving doxorubicin.
- increase body weight, appetite, and activity
- reduce vomiting
What was the response rate (resolution of cytopenia) seen in a study of 11 dogs with myeloid neoplasia (MDS or AML) treated with concurrent Cytosar and doxorubicin? What was the median duration of remission in responders? What was the oMST? Three dogs developed grade V toxicity manifesting as _______ in 2 and ______ in 1.
- RR 64%
- duration of remission: 12 months
- oMST: 12 months
- heart failure = 2
- acute GI side effects = 1
What is the flow cytometry phenotype of an aggressive T-cell leukemia seen in young (median age 3 years) male English Bulldogs? What is the median lymphocyte count and their morphology? Bulldogs that received multi-agent chemotherapy had longer MST’s (_______) than those with no treatment or less aggressive therapy.
- CD4- CD8- MHCII low
- 44k; small to intermediate
- MST w/ multiagent therapy: 3 months
A recent paper evaluating the clinical outcome and prognostic factors in dogs with B-CLL was performed. What was the oMST? What breed was associated with shorter survival time of _______? Cases with high Ki67 had a shorter MST (______) compared to those with low Ki67 (_______).
- oMST: 10 months
- Boxers; MST: 6 months
- High Ki67 (>40%) MST: 6 months
- Low Ki67 (<40%) MST: undetermined
Polyclonal B-cell lymphocytosis in English Bulldogs is characterized by ______ expression on flow cytometry, _________, and hyperglobulinemia with what immunoglobulin in most cases? What is the median age and sex predisposition of these dogs?
- low B-cell class MHCII and CD25
- splenomegaly
- IgA +/- IgM
- 6 years; male
A recent small study in 6 cats with ALL was performed. Of the 5 cats treated with cytotoxic therapy, ___% had partial remission. What was the oMST?
- 40%
- oMST: 2 months
Minimal residual disease in dogs with multicentric lymphoma who achieved CR following therapy was assessed. What was the time to replase (TTR) in dogs with acellular samples, <0.5% infiltration, and >0.5% infiltration?
- TTR acellular samples: 6 months
- TTR <0.5% infiltration: not reached
- TTR >0.5% infiltration: 4 months
A recent study evaluating the outcome and prognostic factors in dogs with epitheliotropic and nonepitheliotropic was performed. The MST was significantly shorter in epitheliotropic dogs (______) compared to nonepitheliotropic (______).
- MST epitheliotropic: 5 months
- MST nonepitheliotropic: 13 months
32 dogs with large cell GI LSA were treated with weekly Elspar injections with a median number of 7 injections. What was the RR based on US and clinical signs, PFS, and MST? ___% developed hypersensitivity.
- RR US: 56%
- RR C/S: 94%
- PFS: 2 months
- MST: 5 months
- 0% developed hypersensitivity
Prognostic significance of peripheral blood and bone marrow infiltration in dogs with nodal marginal zone LSA was assessed. What was the TTP in dogs with peripheral blood infiltration <30% compared to >30%? What were the MST in dogs with BM infiltration <1%, 1-20%, and >20%?
- TTP <30% PB infiltration: 6 months
- TTP >30% PB infiltration: 1 month
- MST <1% BM infiltration: 47 months
- MST 1-20% BM infiltration: 11 months
- MST >20% BM infiltration: 6 months
A study evaluating outcome of dogs with primary high grade mediastinal LSA was performed. The PFS was ____ and the MST was _____. Dogs treated with _____ had improved outcome when compared to other therapies.
- PFS: 4 months
- MST: 6 months
- CHOP
A recent study evaluating diffuse small B cell LSA in dogs found a MST of _____.
5 months
A recent study evaluating outcome in dogs with nodal small B cell LSA treated with CHOP and Ki67 evaluation was performed. What was the PFS, MST, and RR?
- PFS: 2 months
- MST: 9 months
- RR: 50%
In a case control study of cats undergoing renal transplant, ___% developed cancer while on cyclosporine treatment with ___% being lymphoma.
24%
36%
What are some environmental and immunologic risk factors that have been implicated in the development of canine lymphoma?
- pesticide/2-4-D
- Tobacco smoke
- strong magnetic fields
- use of chemicals (paints/solvents)
- industrial areas
- near environment waste
- prior ITP
Hypercalcemia is reported to occur in ___-____% of dogs with lymphoma. ___% of dogs with lymphoma and hypercalcemia had the mediastinal form.
10-40%
43%
Diffuse pulmonary infiltration is seen in __-__% of dogs with multicentric lymphoma.
27-34%
Monoclonal gammopathies have been reported to occur in __% of dogs with lymphoma.
6%
CSF analysis was found to be diagnostic of lymphoma in ___% of samples.
74%
In one study of 53 dogs with lymphoma, __% had circulating malignant cells and were considered leukemic, whereas bone marrow examination indicated involvement in ___% of cases.
- 28%
- 57%
Cranial mediastinal lymphadenopathy is detected in ___% of dogs with lymphoma. Sternal or tracheobronchial lymphdenopathy is seen in ___%.
20%
67%
A group of 55 dogs with lymphoma treated with identical CHOP therapy was evaluated. What were the MSTs reported for dogs with CD3+ vs. CD3- lymphoma? For substage a vs. substage b?
MST CD3+: 5 months
MST CD3-: 13 months
MST substage a: 12 months
MST substage b: 2 months
The expected CR rate for single-agent DOX for lymphoma in dogs ranges from ___-___% with an anticipated MST ranging from ____ - _____.
50-75%
6-8 months
CCNU for naive dogs with lymphoma is associated with a remission duration of _____ in a small case series.
1 month
Regarding biomarkers of minimal residual disease in dogs with lymphoma ______, _______, ______, ______ may be candidates.
- Thymidine kinase 1 activity
- Serum lactate dehydrogenase activity
- haptoglobin
- Serum C-reactive protein
Reinduction rates of ___-___% can be expected in dogs that have completed CHOP-based therapy.
80-90%
Rescue response rates in dogs with LSA are reported to be ___-___% with median response durations of ____- _____. ___% of dogs will enjoy longer response durations.
40-90%
1.5-2.5 months
20%
The ORR for DMAC as a rescue protocol for canine LSA ranges from ___-__% with a CR rate of ___-___%, respectively. The median duration of CR was ____.
43-72%
16-44%
4 months
The ORR for lomustine as a rescue protocol for canine LSA is __% with a CR rate of ___%. The median duration of CR was _____.
27%
7%
4 months
The ORR for lomustine, Elspar, and prednisone as a rescue protocol for canine LSA ranges from ____-___% with a CR rate of ___-___%, respectively. The median duration of CR ranges from ____-____.
77-87%
52-65%
3-4 months
The ORR for DTIC as a rescue for canine LSA is __% with a CR rate of ___%. The mediation duration of CR was ____.
35%
3%
5 months
The ORR for DTIC or temozolomide-anthracycline as a rescue protocol for canine LSA is ___% with a CR rate of ___%. The median duration of remission was _____.
71%
55%
2 months
The ORR for lomustine + DTIC as a rescue protocol for canine LSA is ___% with a CR rate of ___%. The median duration of CR was ____.
35%
23%
3 months
The ORR for mitoxantrone as a rescue protocol for canine LSA is ___% with a CR rate of ___%. The median duration of CR was _____.
41%
30%
4 months
The ORR for MOPP as a rescue protocol for canine LSA is ___% with a CR rate of ___%. The median duration of CR is ____.
65%
31%
2 months
The ORR for MPP as a rescue protocol for canine LSA is ___% with a CR rate of ___%. The median duration of CR is ____.
34%
17%
8 months
The ORR for mustargen, melphalan, vincristine + prednisone (MOMP) as rescue therapy for canine LSA is ___% with a CR rate of ___%. The median duration of CR is ___%.
51%
12%
3 months
The ORR for LOPP as rescue protocol for canine LSA is ___% with a CR rate of ___%. The median response duration was _____.
61%
36%
3 months
The ORR of vinblastine as a second rescue protocol for canine LSA is ____% with a CR rate of ___%. The median response duration was _____.
26%
8%
1 month
The ORR of Tanovea as a rescue protocol for canine B-cell LSA is ___% with a CR rate of ____%. The median duration of CR was _____.
74%
45%
7 months
The ORR of LPP was a rescue protocol for canine LSA is ___% with a CR rate of ___%. The median duration of CR was _____.
61%
29%
3 months
The ORR of temozolomide as a rescue protocol for canine LSA is ____% with a CR rate of ___%. The TTP was ____, and the MST was _____. The ORR of temozolomide/DOX combo therapy is ___% w/ a TTP of ____ and MST of ____. TMZ only has a toxicity rate of ____% whereas TMZ/DOX has a toxicity rate of ___%. Were the differences in TTP statistically significant?
- ORR TMZ: 32%
- CR TMZ: 13%
- TTP TMZ: 15 days
- MST TMZ: 1 month
- ORR TMZ/DOX: 60%
- TTP TMZ/DOX: 19 days
- MST TMZ/DOX: 24 days
- Toxicity TMZ: 46%
- Toxicity TMZ/DOX: 63%
Differences were not statistically different
Small cell T-cell intestinal LSA in dogs treated with chlorambucil and prednisone have reported MSTs ranging from ____-_____.
1.5-2 years
Colorectal lymphoma in dogs generally has a _______ phenotype and is associated with an indolent outcome with PFS and MSTs reported to be _____ after initiation of chemotherapy.
high grade B cell
> 3 years
Canine nodal marginal zone LSA, which is designated as indolent LSA, is generally more aggressive with PFI of _____ and OST of _____.
PFI: 5 months
OST: 9 months
What peripheral blood counts at presentation are associated with a unfavorable prognosis in dogs with LSA. Which is these has a strong association?
- anemia (strong)
- thrombocytopenia
- neutrophilia
- low neutrophil/lymphocyte ratio
- low lymphocyte/monocyte ratio
Of the CLLs in dogs, approximately ____ are T-cell and _____ are B-cell.
T-cell 2/3rds
B-cell 1/3rd
What are the 3 different subtypes of CLL in dogs?
- T-CLL (CD3+, CD8+)
- B-CLL (CD21+)
- atypical CLL
What is the most common immunophenotype of ALL in dogs? List markers.
B-cell (CD21+, CD3-, CD4-, CD8-, +/-CD34+)
What marker distinguishes AML from ALL?
AML: myeloperoxidase +
For canine B-CLL, ___% have peripheral lymphadenopathy, ___% have splenomegaly, ____% have hepatomegaly, ___% have visceral lymphadenopathy, ___% have a mediastinal mass, ___% have hyperglobuminemia, and ___% have hypercalcemia.
50% peripheral lymphadenopathy
50% splenomegaly
30% hepatomegaly
23% visceral lymphadenopathy
3% mediastinal mass
80% hyperglobuminemia
13% hypercalcemia
In dogs with CLL, ____% have monoclonal gammopathy.
68%
Approximately ___% of circulating lymphocytes in normal dogs are T cell and ____% are B cell.
T cell 80%
B cell 15%
In canine CLL, small lymphocytes occur in excessive numbers in the bone marrow (____% of all nucleated cells).
> /= 30%
___% of B-CLL and ___% of T-CLL progress to Richter-like acute disease often characterized by ______ and ____ (clinical signs). The MST after progression is reported to be _____ despite CHOP in 1/2 of patients.
10% B-CLL
2% T-CLL
Lymphadenopathy, neurologic symptoms
MST 1 month
For dogs that are treated for CLL, normalization of lymphocyte count is expected in ___% of cases.
70%
The MSTs reported for T-CLL, B-CLL, and atypical CLL are ____, ____, and ____, respectively.
MST T-CLL: 31 months
MST B-CLL: 16 months
MST atypical CLL: 22 days
In 1 report of dogs with CD34+ ALL, MST was ____ despite majority receiving CHOP.
16 days
Dogs with B-ALL are reported to have MST of ______ independent of treatment protocol
4 months
In a 2008 study of 17 dogs with multicentric lymphoma and bone marrow involvement, cytarabine in addition to a CHOP-based chemotherapy protocol was evaluated. What was the MST in the group of dogs that received cytarabine in addition to CHOP? MST without cytarabine?
MST w/ cytarabine: 8 months
MST w/ out cytarabine: 2 months
A prospective study was designed to evaluate the sensitivity and specificity of abdominal ultrasound for detection of stage IV lymphoma. This study examined 28 dogs with a diagnosis of lymphoma with or without splenic and hepatic involvement. Aspirates were obtained from the liver and spleen in all cases. What was the reported sensitivity and specificity of liver and splenic sonographic appearance for the detection of lymphoma?
Liver
- Sensitivity: 73%
- Specificity: 81%
Spleen
- Sensitivity: 100%
- Specificity: 23%
Serum albumin concentration has been reported to have a positive correlation with survival time in dogs with primary hepatic lymphoma based on a retrospective study on 18 dogs. What is the cutoff of serum ALB concentration in this study that was found to be associated with a significantly shorter MST?
<2.5 g/dL
What is the CR rate of dogs with primary hepatic large cell LSA treated with multi-agent doxorubicin based chemotherapy? What is the oMST?
44%
oMST 2 months
Rabacfosadine has been evaluated as a treatment for dogs with cutaneous T-cell lymphoma. What was the ORR and biologic response rate? What was the median progression free interval for chemotherapy-naive or relapsed dogs
ORR 45%
Biologic response rate 64%
PFS 1 month
FIV infection alone in cats was associated with a ____-fold increase in development of lymphoma.
5
For low grade alimentary lymphoma in cats, ___-cell (T or B?) variants are most likely to occur in the small intestine (___%), and rarely in the stomach or large intestine. The majority of these variants are ______ (mucosal or transmural?).
T cell
94%
mucosal
The majority of B-cell tumors in cats with low grade alimentary lymphoma are ______ (mucosal or transmural?), which is equivalent to WHO EATCL type ____ classification.
transmural
type I
In 1 report of 29 cases of low grade alimentary lymphoma in cats, liver and mesenteric lymph node involvement was documented in __% and ___% of cases, respectively.
liver: 53%
mesenteric lymph node: 33%
Approximately ___% of intermediate to high grade alimentary lymphoma in cats is B-cell and 90% fall under what WHO EATCL classification?
100%
type 1 (transmural)
Feline low grade alimentary lymphoma treated with chlorambucil and prednisolone has a response rate of ____% and MST of ___-_____.
> 80%
1.5-3 years
Feline low grade alimentary lymphoma treated with rescue chemotherapy has a reported MST of ____-_____.
9-29 months
Remission rates of __-___% are reported in cats with intermediate to high grade alimentary lymphoma with ___% achieving CR. For those who achieve CR, MSTs range from _____-____ with a subset living 1 year or longer.
50-65%
30%
7-10 months
Large granular lymphoma in cats has a response rate of ___% with CHOP and CCNU therapies and MSTs ranging from ____-_____. A small subset (___%) have more durable responses of _______.
30%
2-3 months
7%
>6 months
In a study of 23 cats with discrete intermediate to high grade alimentary lymphoma who underwent chemotherapy without surgery, ___% experienced perforation which occurred ___-____ after initiation of chemotherapy. It was included this was likely secondary to ________.
17%
2 days to 3 months
progressive disease rather than chemotherapy-induced perforation
The MST reported in cats with peripheral non-Hodgkin’s LSA is ____-____ whereas the MST with Hodgkin’s like LSA is ____.
non-Hodgkin: 6-9 months
Hodgkin: 1 year
FeLV negative cats with mediastinal LSA have a response rate of ___% with CHOP/COP and MST of _____. FeLV positive cats have a MST of ___-_____.
95%
FeLV negative MST: 12 months
FeLV positive MST: 2-3 months
PARR in cats is approximately ___% sensitive for the diagnosis of lymphoma. Specificity has not been clearly established.
80%
___% of nasal lymphoma in cats has local extension or distant metastasis at necropsy.
20%
In 1 report of 38 cats with nasal lymphoma that was not treated, the MST was ______.
2 months
CR rates of ___-___% are reported in cats with nasal lymphoma treated with RT with MST of ____-_____. For cats that do not achieve CR with RT, their MST is ______.
75-95%
MST CR: 1.5-3 years
MST no CR: 5 months
A total dose greater than ____Gy is recommended for treatment of feline nasal lymphoma.
32 Gy
CR rates of ___% are reported in cats with nasal lymphoma treated with chemotherapy (CHOP or COP) with MST of _____.
75%
2 years
Renal lymphoma in cats is bilateral in ___% of cases.
80%
___% of cats will experience clinical benefit when treated with chemotherapy (COP/CHOP) for renal LSA with MSTs ranging from ______-______.
67%
4-7 months
Generally fewer than __% of cats with CNS lymphoma will respond to chemotherapy with MSTs ranging from ____-_____.
<50%
1-4 months
Popliteal lymph node involvement is seen in ___% of cats with tarsal lymphoma.
20%
___% of cats with subcutaneous lymphoma will die of their disease, indicating a _________ (aggressive or indolent?) biologic behavior.
75%
aggressive
In the largest report of cats with subcutaneous LSA, the PFS was _____ and oMST was ____ following surgical removal.
PFS: 3 months
MST: 5 months
A small number of cases of cats with subcutaneous lymphoma treated with a variety of chemotherapy, MST was reported to be _____.
6 months
In 7 cases of tarsal subcutaneous lymphoma in cats who received RT and chemotherapy, MST was ______.
7 months
____% of cats with laryngeal/pharyngeal/tracheal LSA have regional lymph node involvement.
25%
The CR rate in cats with laryngeal or tracheal LSA treated with chemotherapy (COP/CHOP) is ____% with MSTs after CR ranging from _____-_____ according to Withrow.
90%
6-9 months
Cats with ocular lymphoma treated with enucleation have reported survival times ranging from ______-______.
6 months to 4 years
A bone marrow aspirate with greater than ___% abnormal blasts is sufficient to make a diagnosis of acute leukemia in cats. In cats with CLL, infiltration of bone marrow with >____% mature lymphocytes helps support diagnosis.
> 30% acute leukemia
15% CLL
Approximately ___-___% of cats with ALL are FeLV+. Most malignant cells have a __-cell immunophenotype
60-80%
T cell
In one report of 18 cases of CLL in cats, most were found to be ____ cells. What is the marker positivity?
T-helper (CD3+CD4+CD8-)
Using COP-based protocols, ___% CR rate has been reported in cats with ALL.
27%
In 16 cats treated with chlorambucil and prednisolone for CLL, ____% responded with median duration of ____. ___% achieved a CR with median duration of _____.
90%
6 months
CR: 50%
CR median duration: 14 months
What is the reported response rate for DMAC rescue therapy in cats with lymphoma? What is the PFS and MST from starting DMAC?
26%
PFS 14 days
MST 17 days
What is the reported response rate to CCNU when used as a frontline therapy for feline intermediate to large cell GI lymphoma? Median duration of response? What is the PFI and MST?
50%
median duration of response: 10 months
PFI: 4 months
MST: 4 months
List the subtypes and descriptions of acute leukemias according to FAB system (Hint: there’s 10) and name which one has not been recognized in animals.
- AUL: Acute undifferentiated leukemia
- M1: Myeloblastic leukemia without differentiation
-M2: Myeloblastic leukemia with some neutrophilic differentiation - M3: Promyelocytic leukemia (not recognized in animals)
- M4: Myelomonocytic leukemia
- M5a: Monocytic leukemia without differentiation
-M5b: Monocytic leukemia with some monocytic differentiation - M6: Erythroleukemia
- M6Er: Variant of M6 with erythroblasts comprising erythrocomponent
- M7: Megakaryocytic leukemia
The relative frequency of AML subtypes in dogs in decreasing order are ________ (__%), _______(___%), __________, _______, and one of each for ______ and ______.
- monocytic leukemia (M5a, M5b) 42%
- myelomonocytic leukemia (M4) 33%
- myeloblastic leukemia without differentiation (M1)
- megakaryocytic leukemia (M7)
- Myeloblastic leukemia with some differentiation (M2) and erythroleukemia (M6)
____ is a useful cytochemical marker for AML if neoplastic cells only express CD34.
ALP
Currently, the ACVP Oncology Committee recommends that the following immunophenotyping panel be done on bone marrow and/or blood smears to characterize animal leukemias: for B lymphocytes, ____; for T lymphocytes, ___; for myeloid cells, ___ and _____; for megakaryo-
blasts, _____; for dendritic cells, _____; and for acute leukemias, _____.
- B-cell: CD79a
- T-cell: CD3
- Myeloid cells: myeloperoxidase (MPO) and CD11b
- Megakaryoblast: CD41
- Dendritic cells: CD1c
- Acute leukemias: CD34
Response rates to multi-agent chemotherapy for dogs with AML are ___-___% and MSTs range from ____-____. MSTs for palliative care are ____-____.
50-70%
MST chem0: 0.5-2 months
MST palliation: 1-2 weeks
A case-controlled study evaluating the associations of environment, health history, and T-zone lymphoma in Golden Retrievers was performed. ______, _______, and ______ were significantly associated with T zone lymphoma.
Hypothyroidism
Omega-3 fatty acid supplementation
Mange
Approximately ___-___% of dogs with multiple myeloma will develop osteolytic lesions.
25-67%
High serum viscosity occurs in ___-___% of dogs with multiple myeloma.
20-40%
Renal disease is present in approximately ___-___% of dogs with MM, and azotemia is observed in ____-___% of cats
25-50% dogs
30-40% cats
Bence Jones proteinuria occurs in approximately ___-___% of dogs with MM and ___% in cats.
dogs 25-40%
cats 40%
Hypercalcemia is reported in ___-___% of dogs with MM and ___-___% in cats.
dogs 15-50%
cats 10-25%
For definitive diagnosis of multiple myeloma in dogs, current recommendations require ___% plasmacytosis of the bone marrow. A ___% cutoff in cats with special attention to cellular atypia is also recommended.
> 20% dogs
10% cats
In one case series in cats with MM, ___% of organs with ultrasonographic abnormalities were subsequently confirmed to have plasma cell infiltration.
85%
Reduction in serum total globulin for dogs with MM is expected ____-____ following start of therapy.
3-6 weeks
A good response to therapy for patients with multiple myeloma is a reduction of at least ____% of pretreatment values in the measured M component.
50%
In a group of 60 dogs with MM, approximately ___% achieved complete remission, ___% achieved a partial remission, and ___% did not respond to melphalan and prednisone chemotherapy. The MST was ______.
CR 43%
PR 49%
8% no response
MST 18 months
In a recent group of 38 dogs treated with melphalan/prednisone for MM, ___% had objective responses (___% for pulse-dose protocol and ___% for continuous daily protocol) with PFS of _____ and MST of ________. The 1-, 2-, and 3-year survival rates were ___%, ___%, and ____%, respectively
ORR 86%
94% pulse dose
79% continuous dose
PFS: 20 months
MST: 31 months
1-year: 81%
2-year: 55%
3-year: 30%
List negative prognostic factors for dogs with MM.
Hypercalcemia
Bence-Jones proteinuria
Extensive bony lysis
Renal disease
High neutrophil:lymphocyte ratio
____-____% of cats with MM will respond to therapy. Variable MSTs are reported with a recent compilation reporting ___-____.
50-83%
MST 8-13 months
9 cats were grouped in an “aggressive” and “non-aggressive” category based on clinical features of MM in one small study. The MST of cats with aggressive MM was _____ and ______ for non-aggressive MM.
MST aggressive: 5 days
MST non-aggressive: 13 months
In 9 dogs with IgM macroglobulinemia treated with chlorambucil, ____% achieved remission with a MST of _____.
77%
MST 11 months
Cutaneous plasmacytosis in dogs was associated with lymph node or abdominal viscera involvement in approximately ___% of cases.
30%
In dogs with cutaneous plasmacytosis treated with melphalan or lomustine, response rate is ____%, PFS was ____, and MST was ____.
~75%
PFS 5 months
MST 18 months
Solitary cutaneous or mucocutaneous plasmacytoma in dogs treated with conservative surgical excision have a ___% recurrence rate, and nodal or distant metastasis occurring in ___%.
recurrence rate 5%
metastatic rate 2%
In a compilation of 9 dogs with colorectal plasmacytoma, MST was reported to be ____ after surgery alone.
15 months
The outcome of 18 dogs with CNS LSA was recently assessed. The majority of dogs underwent various treatment (chemo, RT, surgery) besides prednisone alone. The MST was _____.
MST 6 months
A retrospective study evaluating presentation and outcome in 29 dogs with suspected primary renal LSA was performed. What was the response rate to chemotherapy? What was the overall PFS and MST and the PFS/MST of dogs that responded to chemotherapy?
RR 48% (all PR)
oPFS: 10 days
oMST: 12 days
PFS responders: 1 month
MST responders: 2 months
The majority of peripheral, non-TZL, T cell LSA are CD4+ or CD8+?
CD4+
A recent study evaluating the outcome of dogs with peripheral CD8+ or CD4-CD8- T-cell lymphoma was performed. What was the MST of each group? What was the MST based off of large or small cell size determined by flow cytometry?
oMST CD8+: 7 months
oMST CD4-CD8-: 5 months
MST large size: 2 months
MST small size: 9 months
A prospective evaluation of flow cytometric characteristics, histopathologic diagnosis, and clinical outcome in dogs with naive B-cell LSA treated with a 19-week CHOP protocol was performed. Dogs with diffuse large B-cell lymphoma (DLBCL) had an ORR of ___% compared to non-DLBCL subtypes (eg, nodal marginal zone, small B-cell, Burkitt-like, follicular) at ___%. What were the PFS of each groups (DLBCL VS. non-DLBCL)?
DLBCL RR: 96%
Non-DLBCL RR: 70%
DLBCL PFS: 8 months
Non-DLBCL PFS: 5 months
A genetic and environmental risk factor study in boxers with LSA was performed. What risk factors were associated with increased risk for lymphoma in this study popultation?
proximity to nuclear power plants, chemical suppliers, and crematoria
A recent blinded retrospective study assessed ultrasound sensitivity and specificity for lymphoma in both dogs and cats. What were the sensitivity and specificity for liver and spleen? What finding was associated with a B-cell immunophenotype in dogs?
Liver
- sensitivity: ~17%
- specificity: 91%
Spleen
- sensitivity: 73%
- specificity: 94%
leopard-spotted splenic parenchyma
A study was performed to evaluate the impact of various neutrophil cutoffs on chemotherapy administration in dogs with LSA treated with CHOP. They found that a neutrophil cutoff of _____ minimized the number of dose delays and was not associated with increased toxicity. They also found that all dogs with neutrophil count between ____ and ____ recovered without prophylactic antibiotics.
1.5 x 10^3/uL
0.75 - 1.5 x 10^3/uL
Risk factors associated with the onset of lomustine-induced neutropenia in tumor-bearing dogs were assessed in a study out of Europe. A starting dose > _____ was associated with an increased risk of developing neutropenia. A mortality rate of ___% was found in this study population.
> 70mg/m2
1.7%
A comparison of 12- and 19-week CHOP protocols was performed. What was CR rate, PFS, and MST between groups? Was this statistically significant?
CHOP-19:
- CR: 90%
- PFS: 8 months
- MST: 12 months
CHOP-12:
- CR: 89%
- PFS: 5 months
- MST: 8 months
Difference in PFS and MST were statistically significant
A recent retrospective study evaluating the effects of substituting mitoxantrone for doxorubicin in a multi-agent protocol as front-line therapy for dogs with multicentric intermediate to large cell LSA was performed. What were the response rates, PFS, and MST for CMOP and CHOP groups? Were these findings statistically significant?
CMOP
- RR: 100%
- PFS: 6 months
- MST: 8 months
CHOP
- RR: 97%
- PFS: 7 months
- MST: 12 months
PFS and MST were not statistically significant between groups
Cyclophosphamide and prednisolone as initial therapy in naive B-cell LSA dogs was assessed. What was the ORR, CR, PR, and SD rates?
ORR: 84%
CR: 9%
PR: 62%
SD: 12%
A study evaluating the response rate and toxicity of a single dose of vinblastine to dogs with naive multicentric intermediate to large cell was performed. What were the response rates at 2 and 2.5mg/m2? ___% of dogs developed neutropenia 1 week post vinblastine given at 2.5mg/m2.
Vinb 2 mg/m2: PR 7%
Vinb 2.5 mg/m2: PR 60%
80%
A phase II study of 58 dogs with naive or progressive B- or T-cell LSA evaluating KPT-335 (verdinexor/Laverdia) was performed. What was the overall ORR? ORR for T-cell LSA? What was the most common adverse event?
ORR 37%
ORR T-cell: 71%
Anorexia
What is the dose and schedule of Laverdia (verdinexor/KPT-335)?
1.5 mg/kg PO 3 times weekly
A phase I study of 18 dogs with peripheral nodal lymphoma treated with survivin inhibitor, EZN-3042, was performed. What was the established dose/schedule that reduced majority of survivin expression? Any DLTs?
8.25mg/kg IV twice weekly
No DLTs were observed
Concurrent use of Tanovea and Elspar for relapsed or refractory multicentric lymphoma in dogs was prospectively evaluated. What was the ORR, CR rate, oPFS, and PFS for CR dogs?
ORR: 67%
CR: 41%
oPFS: 2 months
PFS CR: 5 months
A retrospective study evaluated the efficacy and tolerability of combination therapy with DTIC and mitoxantrone in dogs with relapsed lymphoma. ___% experienced grade 4 neutropenia. The overall RR was ____ for a median of _____. For dogs that received this as first rescue, the RR was ____%.
18% grade IV neutropenia
oRR: 34%
Median duration of response: 3 months
RR first rescue: 93%
What is the ORR to MVPP in dogs with relapsed multicentric lymphoma? PFS? MST?
ORR: 25%
PFS: 15 days
MST: 2 months
A study in 2018 evaluated LOPP as first-line therapy in 35 dogs with multicentric T-cell LSA. What was oPFS and oMST? ___% achieved CR with a PFS of ____. What was the toxicity rate?
- oPFS: 14 months
- oMST: 17 months
- CR: 83%
- PFS CR: 17 months
- Toxicity rate: 86%
A retrospective study evaluating combination Elspar + CHOP vs. modified MOPP in dogs with multicentric T-cell lymphoma was performed. What was the PFS in each group? What breed had longer PFS in CHOP vs. MOPP?
- PFS L-CHOP: 4 months
- PFS MOPP: 3 months
- Golden retrievers
A retrospective study of 31 dogs with multicentric T-cell LSA treated with LOPP as first-line was performed in 2017. What was the ORR, DFI, and MST?
- ORR 97%
- DFI: 6 months
- MST: 11 months
What is MST for dogs with previously untreated multicentric intermediate to large cell lymphoma treated with prednisone alone?
50 days
What is the ORR of procarbazine, cyclophosphamide, and prednisone (PPC) therapy in dogs with relapsed lymphoma or those that do not tolerate MTD chemo?
- ORR: 70%
- PR: 24%
- CR: 46%
What is the cure rate of autologous peripheral blood hematopoietic stem cell transplantation (HCT) in dogs with high grade B-cell lymphoma?
33-40%
What is the DFI and MST in dogs with high grade B cell lymphoma treated with allogeneic peripheral blood hematopoietic stem cell transplantation (HCT)? A cure rate of ___% was found, meaning that allogeneic HCT can cure ~___% more dogs than autologous HCT.
- oDFI: 37 months
- oMST: 37 months
- 89%
- 50%
A recent retrospective study compared outcome in cats with sinonasal lymphoma treated with hypofractionated RT (HRT) + CHOP/COP-based chemotherapy vs. HRT alone. What were the PFS and MST of each group?
HRT + chemo:
- PFS: 23 months
- MST: 33 months
HRT alone:
- PFS: 4 months
- MST: 9 months
A recent retrospective study evaluating 23 cats with laryngeal or tracheal lymphoma treated with chemotherapy +/- surgical debulking (26%) was performed. What was the PR and CR rates? What was the PFS and MST? Immunophenotyping was performed in 48% of cases and all were __-cell.
- PR: 35%
- CR: 65%
- PFS: 30 months
- MST: 30 months
- B-cell
A retrospective study evaluating outcome of 32 cats treated with SBRT for nasal lymphoma was performed. What was the PFS, MST, acute toxicity rate, and chronic rhinitis rate? What factors were associated with shorter outcome?
- PFS: 8 months
- MST: 12 months
- Acute toxicity: 0%
- 75% chronic rhinitis
- cribiform lysis and intracranial involvement
A retrospective study evaluating incidence and treatment of renal lymphoma in 27 cats was performed. Cats treated with prednisolone alone had a MST of ____ compared to cats treated with L-CHOP at ______.
- MST pred: 50 days
- MST L-CHOP: 7 months
Lomustine, methotrexate, and cytarabine for rescue chemotherapy for large cell lymphoma in 13 cats was assessed. In cats that received all 3 drugs, ___% demonstrated a complete or partial response to therapy. What was the PFS?
46%
PFS 2 months
A prospective study of 12 cats with intermediate to large cell GI LSA treated with lomustine and 8 Gy abdominal cavity radiation therapy was performed. ___% developed cytopenias, resulting in treatment delays. The overall RR was ___% (all PR). What was PFS and MST?
- 44% cytopenia
- ORR 50%
- PFS: 3 months
- MST: 3 months
Outcomes of 40 cats with discrete intermediate to large cell GI lymphoma treated with surgery was assessed. Cats that survived to suture removal had a MST of _____. Cats with a large intestinal mass and complete resection had improved MST (LI MST: ____; complete resection ____).
- oMST 6 months
- MST LI: 23 months
- MST Complete resection: 12 months
What is the reported response rate of MOPP as rescue therapy for cats with lymphoma? Among responders, the median response duration was _____. The most common adverse effects were neutropenia and GI upset, which were reported in ___% of cases.
- ORR: 70%
- Median response duration: 6 months
- 18%
Large cell LSA has been reported to occur in ___% of cats treated for small-cell GI LSA.
10%
____% of cats achieve a CR with cyclophosphamide rescue therapy for small-cell GI LSA for a median duration of _____.
90%
8 months
A retrospective evaluation of the use of the International Myeloma Working Group response criteria in dogs
with secretory multiple myeloma was performed. MST was longer for dogs that attained ≥90% densitometric M-protein reduction (____) than for those that did not attain at least 50% reduction in densitometric M-protein (_____). What response diagnostics did not correlate with outcome?
- MST >90%: 21 months
- MST: <50%: 10 months
- Serum globulins and radial immunodiffusion (RID)
Cyclical 10-day dosing of melphalan for canine multiple myeloma was reported. Based on serum globulin concentrations, ___% achieved CR, and ___% achieved PR, for an overall response rate of ___%. The MST was ____. Adverse events were minimal with ______ being the most reported.
CR: 59%
PR: 18%
ORR: 76%
MST: 17 months
diarrhea
Response and outcome following radiation therapy of macroscopic canine plasma cell tumors was evaluated. ___% achieved CR, ___% achieved PR for an ORR of ___%. The PFS was _____. MST for non-MM cases was _____ and for all cases was _____.
CR: 73%
PR: 23%
ORR: 95%
PFS: 20 months
MST non-MM: 26 months
oMST: 23 months
A recent retrospective evaluation of the outcome of solitary osseous plasmacytoma in 13 dogs was performed. What was the most common site? What was the overall PFS and MST? What was MST following completion of radiation therapy? ___% progressed to multiple myeloma.
- vertebrae
- PFS: 10 months
- oMST: 30 months
- MST RT: 39 months
- 0%
A retrospective study of canine oral extramedullary plasmacytoma over a 15-year period was performed. The MST after various treatment (surgery, RT, and/or chemotherapy) was ______. ___% of dogs had progression of plasma cell disease with ___% being myeloma-like. Cases without tumor progression did not exceed ___ mitotic figures in ten HPFs.
- MST: 32 months
- ~ 30%
- 4%
- 28 MC
