Oncology Flashcards
What is the staging system for canine lymphoma?
Stages I: single LN, II: multiple LNs, III: regional LNs, IV: liver and/or spleen, V: distant metastasis.
Substaging: a - systemically well. b - systemically unwell.
Canine multicentric lymphoma - treatment options and prognosis?
- Multiagent - CHOP. Remission rate >90%, DFI 12 months. 4-6 week cycles.
- Single agent - doxorubicin (+ steroid).
Chronic lymphocytic leukemia (CLL) - criteria for treatment?
Lymphocyte count >60K
Organomegaly (infiltrative disease)
Most common form - T cell, granular form.
CLL - treatment and prognostic factors?
Chlorambucil and prednisolone - long term
Overall good prognosis
Negative - anemia, immunophenotype (B cell worse than T)
Cell surface markers for vascular neoplasia
CD31
Vimentin (spindle cell)
Factor 8
Cell cycle non-specific drugs?
Anti-tumor antibiotics (doxo, mitoxantrone)
Cell cycle specific drugs?
Alkylating agents (vinc-)
MDR-positive dogs - pathogenesis and considerations?
ABCB1 gene mutation (aka Multi Drug Resistance 1 gene) - deletion in 4 base pairs. Gene encodes for p-glycoprotein - affects drug efflux from cells. Most significant implication in epileptic control (often more refractory to conventional anti-epileptic drugs in Collies).
Overall <2% prevalence (UK, presumably Aus).
MDR - which drugs?
Alkylating agents (vincristine, vinblastine, vinorelbine), paclitaxel.
NOT cyclophosphamide, CCNU, doxorubicin.
Chemotherapeutic drugs that cross the BBB
Lipophilic drugs:
Procarbazine
Alkylating agents - lomustine (CCNU), temozolomide
Multiple myeloma - diagnostic criteria (list 4)
1) Neoplastic plasma cells in the BM/tissues
2) Lytic bone lesions
3) Monoclonal gammopathy (serum)
4) Bence Jones proteinuria (urine fLC)
3 & 4 - presence of clonal Ig
paraproteins produced by neoplastic cells (M-proteins) - can be complete Ig or free light chains (fLC).
Multiple myeloma - clinical manifestations & mechanisms?
Hyperviscosity syndrome - bleeding diathesis (M component interferes with platelet aggregation & platelet factor 3 release)
Systemic hypertension
Renal dysfunction
Lameness/bone pain
Immunosuppression - secondary/acquired infections
Cytopenias (anemia, thrombocytopenia)
Hypercalcemia (D>C)
Multiple myeloma - treatment?
Melphalan and prednisolone
Pamidronate (if osteolytic lesions)
Lomustine (CCNU) + hepatoprotectant
Multiple myeloma - prognosis?
MST 540-930 days with PO chemotherapy
Soft tissue sarcoma (STS) grading system?
Grade I & II: low grade
Grade III: high grade
Histologic grade is PROGNOSTIC
Grading system for neutropenia?
Grade 1-4
Cyclophosphamide MOA?
Alkylating agent
Cyclophosphamide adverse effects and MOA?
- Haemorrhagic cystitis (via renal excretion of its hepatic metabolite acrolein which is urotoxic)
- Myelosuppression (neutropenia)