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Oncology Boards > LSA - feline > Flashcards

LSA - feline Flashcards

1
Q

What were the most common anatomic forms of LSA in cats and what were the associated phenotypes in most cases? (Leite-Filho VCO 2019)

A

33% alimentary - T cell

28% mediastinal - B cell (also usually young FeLV + cats)

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2
Q

What % of cats with small-cell GI LSA develop a second malignancy? What % developed large cell LSA? (Wright JFMS 2018)

A

7-14% of cats developed a second malignancy

9.9% of cats treated for small cell GI LSA developed large cell LSA

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3
Q

For cats with small cell GI LSA that then developed large cell LSA, what changes (clinical signs or blood work) were noted when they developed large cell LSA? What was the MST after developing large cell LSA? (Wright JFMS 2018)

A

Weight, HCT, albumin and total protein significantly decreased when cats developed large cell LSA

MST 24.5d

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4
Q

Feline primary cutaneous LSA (non-injection site) accounts for what % of LSA in cats and is typically what morphology/phenotype? (Roccabianca Vet Path 2016)

A

0.2-3% of all feline LSA

Usually dermal nonepitheliotrophic small cell T cell

Unrelated to FeLV or skin inflammation

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5
Q

What were the phenotypes of cutaneous LSA that developed at injection sites in cats? Also, what other protein was expressed in 10/17 tumors? (Roccabianca Vet Path 2016)

A

11 large B, 3 anaplastic large T cell, 1 NK-like, 1 peripheral T

10/17 expressed FeLV proteins - thought that inflammation and reactivation of FeLV expression may contribute to emergence

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6
Q

What was the ORR response to DMAC in cats as a rescue agent for LSA? (All cats had COP first line, most had at least 2 prior rescue therapies). PFS and OST? (Elliot VCO 2018)

A

Responsse 26% (5/19), PFS 14d, OST 17d

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7
Q

What was the response rate and median duration of response for cats treated with MOMP as a rescue for LSA? (Martin JFMS 2017)

A

3CR and 4PR (ORR 58%)

Median duration 39d, but range 14-345d and cats that acieved CR = sig longer PFS

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8
Q

In a survey of owners, what % were happy they elected to treat with CHOP for LSA in their cat? What were the main QOL parameters identified? (Thornton JFMS 2017)

A

75% happy

Appetite, vomiting and diarrhea

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9
Q

What was the RR and median duration of response for cats with intermediate to large GI LSA treated with CCNU as first line? mPFI and MST? (Rau VCO 2017)

A

RR 50%, median duration 302d

mPFI 132d, MST 108d

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10
Q

What was the ORR (and % PR vs CR) in cats with high or intermediate grade LSA treated with CHOP-12? Duration of response? (Limmer VCO 2016)

A

ORR 74% - 47% CR, 27% PR

Duration: CR = 394d; PR = 41d

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11
Q

What was the OST for cats with high or intermediate grade LSA treated with CHOP-12? What about if CR or PR? (Limmer VCO 2016)

A

OST 78d

MST for CR 454d

MST for PR 82d

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12
Q

What was the DFI and MST for cats with high grade GI LS Atreated with surgery and adjuvant CHOP? (Gouldin VCO 2015)

A

DFI 357d, overall MST 417d

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13
Q

What % of cats developed a perforation during treatment for discrete intermediate or large cell GI LSA? When did it occur in cats? (Crouse FJMS 2017)

A

17% (4/23 cats)

ocurred 23, 56, 59 or 87d post-starting chemo –> not acute with onset of chemotherapy like it is typically reported in people

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14
Q

What was the mPFS and MST for cats with int. to high grade LSA treated with modified UW-CHOP? What about cats with CR in particular? (Collette VCO 2016)

A

mPFS =56d, MST=97d

CR = biggest prognostic factor - CR PFS 205d (6.8mo) and MST 318d (10.6mo) vs. no response PFI 21d and MST 27d

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15
Q

What was the mPFI for cats treated with CCNU as a rescue agent for resistant LSA? (Dutelle JFMS 2012)

A

mPFI 39d - 21d for large cell vs. 169d for small/intermediate

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16
Q

What was the ORR, median duration of response and MST for cats treated with long term multiagent chemo (l-spar, vinc, ctx, dox, methotrexate and pred x122wks) (Simon JVIM 2008)

A

CR 74%, PR 14%

Median duration of response for CR 264d, MST of CR 296d

PR MST 38-120d

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17
Q

What was the ORR to cats with LSA treated with L-spar? What levels were decreased after treatment and when? (LeBlanc JVIM 2007)

A

ORR 30% to 400IU/kg

Increased ammonia and aspartate after tx

Decreased asparagine at day 2 after tx (not day 7)

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18
Q

What was the clinical response rate to chlorambucil/steroids in cats with small-cell GI LSA in cats? median remission duration? (Stein JAAHA 2010) **Committee member**

A

Clincial response 96%, median remission duration 786d (26.2mo = 2.2yrs)

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19
Q

For the cats with small cell GI LSA treated with chlorambucil/roids that had relapsed disease, what was the response rate to cytoxan + steroids? (Stein JAAHA 2010) **Committee member**

A

100% responded (7/7 cats)

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20
Q

What was the response rate to treatment in cats with extranodal (most common nasal, renal and CNS) (treatment = COP or CHOP, other chemo or steroids) (Taylor JSAP 2009)

A

85.5%

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21
Q

What was the MST for cats with extranodal LSA treated with chemo (primarily COP or CHOP)? What location was the best? How about the worst? (Taylor JSAP 2009)

A

CR MST 239-563d

Nasal LSA if CR = longest MST 749d

CNS shortest 70d

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22
Q

What was the clinical response in cats with LSA to weekly COP after the first cycle? What was the OST for responders vs. nonresponders? (Waite JAVMA 2013)

A

response after 1st cycle = 47%

If CR, OST = 591d vs. 73d

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23
Q

What % of cats with low grade GI LSA had low cobalamin levels? (Kiselow JAVMA 2008)

A

78%

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24
Q

What was the difference in cats treated with a COP based chemo protocol with VBL or Vinc? (vinca, ctx, vinca, methotrexate) (Krick JVIM 2013)

A

Similar response rates, PFS and LSS

Vinc had more GI toxicity (44% vs. 10.5%)

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25
Q

What was the response rate to doxorubicin as a rescue agent for feline LSA after treatment with other chemo protocols? (Oberthaler JFMS 2009)

A

22% (5/23 cats) - 17/23 cats only had one dose of doxo b/c didn’t respond

author’s conclusion: doxo not a good rescue option for feline LSA

26
Q

What was the response rate and MST (overall vs. CR vs. PR) for cats treated with UW-CHOP25 for LSA? (Milner JAVMA 2005)

A

Response: 47%CR, 37%PR

overall mst 210d

CR MST 654d

PR MST 122d

NR MST 11d

27
Q

What was the CR rate and remission duration in cats treated with IP-COP (+l-spar)? Overall MST? How was it tolerated? (Teske VCO 2012)

A

CR: 76.9%, median remission duration 421d

MST 388d

No specific IP-related AEs (vinc and ctx used at higher doses IP - 0.75mg/m2 and 300mg/m2)

28
Q

Was high resolution melting analysis (HRM) after PCR better than the standard electrophoretic separation of the PCR products in feline LSA? (Henrich Vet Immuno 2018)

A

No, standard capillary electrophoresis ID’d 3 LSA not detected by HRM, but overall PARR performance was crappy - no false positives, but standard electrophoresis only was positive in 14/47 lsa samples

29
Q

What were the sensitivity and specificity of a spleen with a moth-eaten parenchymal appearance for predicting malignant neoplasia in cats? (Bertal JFMS 2018)

A

Sensitivity 13.2%, specificity 84.8%

i.e. moth-eaten US appearance of spleen in cats does not necessarily reflect malignancy on cytology

30
Q

What were the sensitivity and specificity of a splenic mass >1cm on AUS predicting malignant neoplasia in cats? (Bertal JFMS 2018)

A

Sensitivity 21%, specificity 94.7%

i.e. presence of a splenic mass >1cm is suggestive of malignancy in cats

31
Q

What can help to improve the detection of a marbled or moth-eaten spleen on AUS in cats? (Bertal JFMS 2018)

A

High frequency transducer

32
Q

What size needle provided the highest cellularity (and therefore better samples for flow) for sampling lesions in cats with LSA (Martini JFMS 2017)

A

21 Ga ( no variation between peripheral and intra-abdominal lesion sampling, but 50% of cats needed sedation)

33
Q

What is the characteristic ultrasound appearance of feline renal LSA and what was the sens/spec and PPV/NPV? (Valdes-Martinez VRU 2007)

A

hypoechoic subcapsular thickening

PPV 80.9%, NPV 66.7%

Sensitivity 60.7%, specificity 84.6%

34
Q

What % of cats with newly diagnosed LSA had ocular changes and what were the most common changes present? (Nerschbach VCO 2013)

A

48%

Most common: uveitis anterior or posterior

other: exophthalmos, corneal lesions, chemosis

35
Q

What % of cats with LSA showed lung infiltration (when examined at necropsy)? Of these, what % had no gross abnormality? (Leite-Filho J comp path)

A

12.8% showed lung infiltration, 56.2% had no gross abnormalities (25% had masses, 18.7% had nodules)

36
Q

What was the most common histologic pattern of pulmonary LSA involvement? What % of cats had more than 1 pattern present? (Leite-Filho J Comp Path 2018)

A

93.7% = peribronchial-vascular infiltration (others pleural 56.2%, interstitial 50%, nodular 37.5%0 alveolar 12.5%)

75% had more than 1 pattern

37
Q

What was the most common immunophenotype and subtype of feline LSA with pulmonary involvement? (Leite-Filho J compa path 2018)

A

87.5% B-cell

DLBCL most common subtype (56%)

38
Q

When categorized by WHO classification, which forms of feline LSA were associated with a better prognosis? (Wolfesberger JFMS 2017)

A

Intestinal T-cell (MST 1.7yrs) and T-cell-rich-B-cell (MST 1.2yrs)

39
Q

Which GI locations of LSA in cats are associated with a B vs. T cell phenotype? (Pohlman Vet Path 2009)

A

All gastric LSA B cell - predominantly diffuse large immunoblastic

SI 52% T cell

Large intestinal 88% b cell

40
Q

Matrix metalloproteinase-9 is (increased/decreased) in cats with LSA compared to controls and these levels (increase/decrease) with treatment. (Tamamoto VCO 2014)

A

increased in LSA cats

Decreased levels with treatment

41
Q

Was duodenal MDR1 and COX2 expression was higher in cats with IBD or LSA?

A

Higher in cats with LGAL compared to IBD

Healthy control cats had lower levels than both LSA and IBD

42
Q

What is nutlin-3 and what does it do to feline LSA cell lines? (Mochizuki Vet Immuno and immunopath 2012)

A

MDM2 inhibitor

Induced cell cycle arrest and apoptosis with wild type p53, induceld cell cycle arrest with mutant p53

43
Q

What human monoclonal antibodies were used to assess p-glycoprotein expression in feline LSA? What was the median remission and MST for these cats, and how did P-gp expression correlate with outcome? (Brenn VCO 2008)

A

MAb C219 and 40

Median remission 164d, MST 571d (most cats treated with CHOP)

P-gp expression no predictive of outcome

44
Q

How was change in weight related to prognosis for cats with large cell LSA treated with chemo? (Krick JFMS 2011)

A

Cats that lost >5% of body weight at 1mo had shorter LSS than those that were stable or gained

45
Q

What radiation protocol as been used in cats as a rescue for GI LSA and what was the response and outcome (MST/OST)? (Parshley JFMS 2011)

A

2x8Gy over 2 days

response in 10/11 cats

MST post-RT = 214d, OST = 355d

46
Q

What GI location of int to lg cell LSA in cats was associated with the longest MST when treated with surgery +/- chemo? (Tidd Vet surg 2019)

A

Large GI - MST 675d

compared to SI (64) or gastric (96d)

47
Q

What was the MST for cats that were treated with surgery +/- chemo for discrete intermediat or large cell LSA? What was associated with a better survival? (Tidd vet surg 2019)

A

MST 185d

complete sx resection = better survival (370d vs. 83d)

treatment with chemo did not affect outcome

48
Q

What bacterial spp were found to be higher in GI biopsies of cats with small cell GI LSA vs. IBD? (Garraway JVIM 2018)

A

Fusobacterium (also correlated with CD11b+ cells and NF-kB expression) and bacteroides spp.

49
Q

What was the overall mTTP and MST for cats with large granular LSA treated with a variety of therapies? What % of cats lived >6mo? (surgery, chemo, steroids, no treatment) (Finotello VCO 2018)

A

mTTP 5d, MST 21d

7% lived >6mo

50
Q

_____ was found to be elevated in 50% of cats with large granular lymphoma (Finotello VCO 2018)

A

LDH

51
Q

What was the more common immunophenotype for SQ extranodal feline LSA and what was the overall behavior of this cancer? (Meichner VCO 2016)

A

68% B cell (+ low presence of retroviral infection)

Aggressive - 32% had distant involvement at another SQ site

52
Q

What were the mPFS for cats with SQ extranodal LSA treated with surgery, surgery + chemo or RT, or chemo alone? What was the median OST? (Meichner VCO 2016

A

Surgery PFS 73d

Surgery + chemo or RT 756d

Chemo alone 108d

mOST 148d

53
Q

What was the DFS for cats with nasal LSA treated with RT + chemo vs. RT alone vs. chemo alone? (Haney JVIM 2009)

A

RT + chemo = 473d

RT alone = 1431d

Chemo alone = 320d

Not stat different

54
Q

Cats that had a total RT dose ≥ _____ for treatment of nasal LSA had a better outcome (Haney JVIM 2009)

A

≥32gy

55
Q

What was the MST for cats with stage I nasal LSA treated with megavoltage RT and what % relapsed distantly? (Sfiligoi VRU 2007)

A

MST 955d

17.6% relapsed distantly

56
Q

What was the response rate to chemo (COP or CHOP), overall MST and MST for CR vs. PR in cats with mediastinal LSA? What was unique about this population of cats?(Fabrizio JFMS 2013)

A

Unique: young cats (median 3yrs), siamese 21.8% of cats, males increased risk (3.2:1)

94% response rate

Overall MST 373d

CR = 980d vs. PR=42d

57
Q

What % of cats with tarsal LSA had LSA elsewhere (either at time of death or lost to follow up)? What was the MST for cats with tarsal LSA? (Burr JAVMA 2014)

A

13/23 had LSA elsewhere (56.5%), MST 190d

58
Q

What was the rate of remission, duration of response and MST for cats with gastric LSA treated with chemo? (Gustafson JAAHA 2014)

A

75% remission

PR: 125d remission, MST 138d

CR: 189d remission, 431d MST

59
Q

What is characteristic of Hodgkin’s-like LSA in cats? (Walton Vet Path 2001)

A

Slowly progressive, arises in a single nod or chain & spreads vi contiguous nodes

Histo: heterogenous population of lymphoid and inflammatory cells - minority of malignant Reed-Sternberg cells (multinucleated B cells)

60
Q

What are the most common areas of the SI affected by small cell LSA in cats? (Lingard JFMS 2009)

A

jejunum > ileum > duodenum

61
Q

What was the ORR and mPFI of cats with small cell LSA treated with steroid and chlorambucil (tx d/c if CR at 1yr). What rescue was best for these cats if they had disease recurrence? (Pope Vet Med and Sience 2015)

A

ORR 85.7%, mPFI 1078d

restarting pred/chlorambucil better PFI and ST than pred/CCNU

overall MST 1317d

62
Q

What was the viral status for cats with large granular LSA? What was the response rate to chemo and MST? (Krick VCO 2008)

A

All cats FeLV/FIV negative

1/23 CR, 6/23 PR (30% RR)

MST 57d

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