Lecture 6 Flashcards
Breeds predisposed to lymphosarcoma
Boxer, Basset Hounds, St. Bernards, Scottish terriers, Airdales, Bulldogs, Rottweillers, Golden Retriever
»Age average 6-7 years
lymphosarcoma is often what cell line
B cell
Diagnosing lymphoma
–Cytology •Flow cytometry •Immunocytochemistry •PARR assay –Histopathology •Immunohistochemistry
Stages of Lymphoma
- I- Single node (or organ)
- II- Group of nodes on one side of diaphragm
- III- Generalized lymph node involvement
- IV- Spleen or liver involvement
- V- Bone Marrow, CNS, or other organs
- a- no symptoms b- symptoms / sick
Anatomical classifications of lymphosarcoma
–Multicentric –Gastrointestinal –Mediastinal –Cutaneous –Extranodal
Histological classifications of lymphosarcoma
–Low grade (small cell)
–Intermediate grade (diffuse large cell)
–High grade (Immunoblastic)
Survival in dogs following treatment with chemo?
1 year
factors associated with poorer prognosis in dogs
–Substage b –Stage greater than III –T-cell –Hypercalcemia –Icterus –Hypoproteinemia –Prior prolonged treatment with glucocorticoids
drugs used to treat lymphosarcoma in dogs
–Prednisone- corticosteroid
–L-aspariginase (Elspar)- enzyme, anti-metabolite
–Vincristine (Oncovin)- mitotic spindle interrupter
–Cyclophosphamide (Cytoxan)- alkylator
–Doxorubicin (Adriamycin)- antitumor antibiotic
–Methotrexate- antimetabolite
–Lomustine- alkylator
–Tanovea- newer targeted therapy for Canine lymphoma
protocol for canine lymphosarc relapse
•What to do at relapse?
–Start your protocol over (if > 6 months from induction)
–Switch to a new protocol with new drugs (more common with T cell)
–Rescue protocols
rescue protocols for dogs
- Lomustine +/- Elspar
- MOPP (mechlorethamine, vincristine, procarbazine, prednisone)
- Doxorubicin and DTIC
- Mitoxantrone
- Bleomycin + ?
older cats get what kind of lymphosarcoma?
GI/abdominal
younger cats tend to get what time of lymphosarc?
FeLV, mediastinal
anatomic classification of lymphosarc in cats
- Alimentary / GI
- Mediastinal
- Multicentric
- Nasal
- Renal
- Spinal (check bone marrow)
- Leukemia
consideration regarding stage classification of LSA in cats
- Multiple schemes but not as helpful as in the dog
- Anatomical classification most useful
- Single organ involvement tends to do better
treatment of high grade LSA in cats
–Same drugs as in dogs, but cats are more likely to experience side effects
–Two protocols here:
•COP +/- Elspar (intermediate grade)
•Madison Wisconsin 6 month protocol- addition of doxorubicin important for internal forms
–Single node or nasal- radiation therapy useful but be sure the cat has stage I disease only
classification of leukemias
–acute or chronic
–lymphocytic or non-lymphocytic
–aleukemic leukemic refers to a proliferation in the one marrow without the appearance of the abnormal cells in the peripheral blood
diagnosis of leukemia
Bone marrow exam
–Assists in diagnosis of cell type (lymphocytic or myelogenous)
–Also aids in estimating prognosis – shows what is still present in bone marrow
–May require IHC for definitive diagnosis
treatment for acute lymphocytic leukemia
- Protocol should contain an Anthracycline and Elspar +/- Cytosar.
- Support therapy can be difficult if all cell lines are damaged.
- Remission time is shorter than for solid forms.
treatment for acute nonlymphocytic leukemia
–therapy must be aggressive and begun ASAP
•Cytosine Arabinoside
•Combinations of cytosine arabinoside and an anthracycline
•Support therapy can be extremely difficult- no white cells, no platelets, no red cells are being made in adequate quantities until a remission is achieved.
incidence of chronic leukemia in the dog vs cat
commonish in dogs and rare in cats
treatment of chronic leukemia
–Chlorambucil (2-6 mg/m2) every other day alternating with prednisone (20 mg/m2) every other day.
–Survivals can be quite long-1-3 years
