Retrospective analysis of doxorubicin and prednisone as first-line therapy for canine B-cell lymphoma

Sami Al-Nadaf,Jennifer L Willcox,Rachel O Venable,Jenna H Burton,Katherine A Skorupski,Kaitlin M Curran,Robert B Rebhun

doi:10.1186/s12917-018-1688-5

Abstract

BackgroundA doxorubicin (DOX)-based chemotherapy protocol, CHOP, is the most effective treatment for canine high-grade B-cell lymphoma; however, the cost and time requirements associated with this protocol are not feasible for many pet owners. An alternative treatment option is the use of DOX, the most effective drug, in combination with prednisone. Prior studies with single-agent DOX included dogs with T-cell lymphoma, a known negative prognostic factor, which may have resulted in shorter reported survival times than if dogs with B-cell lymphoma were analyzed separately. The purpose of this study was to evaluate the outcome of dogs with high-grade B-cell lymphoma when treated with DOX and prednisone with or without L-asparaginase (L-ASP). Identification of prognostic factors was of secondary interest.ResultsThirty-three dogs were included in the study; 31 dogs were evaluable for response with an overall response rate of 84%. The median progression free survival (PFS) and overall survival (OS) were 147 days and 182 days, respectively. The one-year survival fraction was 23%. No variable other than protocol completion was found to be significant for either PFS or OS including historical prognostic factors such as substage, thrombocytopenia, and body weight.ConclusionsDogs with high-grade B-cell lymphoma treated with DOX and prednisone with or without L-ASP have similar response rates, PFS, and OS to prior studies that did not differentiate between lymphoma immunophenotype. This protocol is not a replacement for CHOP; however, it is an alternative if time and cost are factors, while providing therapeutic benefit greater than prednisone alone.

Highlights

A doxorubicin (DOX)-based chemotherapy protocol, CHOP, is the most effective treatment for canine high-grade B-cell lymphoma; the cost and time requirements associated with this protocol are not feasible for many pet owners
Patient characteristics Thirty-three dogs with high-grade B-cell lymphoma treated with at least one dose of DOX between January 2008 and December 2015 were included in the study
This study sought to determine the response rate, progression-free survival (PFS), and overall survival (OS) for dogs with B-cell lymphoma when treated with a DOX and prednisone protocol with or without L-ASP induction; we hypothesized that dogs with B-cell lymphoma would have an improved response rate and outcome as compared to previous studies that included dogs with T-cell forms of lymphoma

Summary

Introduction

A doxorubicin (DOX)-based chemotherapy protocol, CHOP, is the most effective treatment for canine high-grade B-cell lymphoma; the cost and time requirements associated with this protocol are not feasible for many pet owners. DOX is the most effective single-agent drug for the treatment of canine high-grade lymphoma and DOX combined with prednisone may be offered as an alternative option to CHOP [13, 14]. This may be a more practical treatment for owners seeking to extend quality of life beyond that obtained with prednisone alone, but who are interested in a less intense protocol in terms of frequency and total number of treatments as well as cost [9]. Previous studies evaluating DOX administered every 3 weeks for 5 to 6 treatments have not examined the association of patient outcome and immunophenotype This raised the question as to whether prior studies that included dogs with T-cell lymphoma may underestimate survival times for dogs with B-cell lymphoma treated with single-agent DOX. Identification of factors associated with improved patient outcome was a secondary objective

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