Lymphoma In Cats Research Articles

Pathological Characterization of Lymphoma with Pulmonary Involvement in Cats

Studies evaluating histological patterns of lung infiltration by lymphoma in cats are lacking. We evaluated retrospectively the histological patterns of 125 necropsy cases of feline lymphoma collected over a 12-year period. Of the 125 cases, 16 showed lung infiltration (12.8%). Nine cats were female, seven cats were male and all were of mixed breed. Gross lesions observed in the lungs consisted of masses (25%) and nodules (18.7%); however, the majority of cases (56.2%) did not show any gross abnormality. Peribronchial-vascular infiltration (93.7%) was the most frequent pattern, followed by pleural (56.2%), interstitial (50%), nodular (37.5%) and alveolar (12.5%) patterns, but 75% of the cases had more than one pulmonary infiltration pattern. There were 14 (87.5%) B-cell and two (12.5%) T-cell lymphomas. Six cats (37.5%) were positive for feline leukaemia virus and three cats (18.7%) were positive for feline immunodeficiency virus. Diffuse large B-cell lymphoma was the most frequent type, accounting for 56% of all cases.

Relationship of the mucosal microbiota to gastrointestinal inflammation and small cell intestinal lymphoma in cats.

BackgroundThe gastrointestinal (GI) microbiota in healthy cats is altered in IBD. Little research has been performed to identify whether specific bacterial groups are associated with small cell GI lymphoma (LSA).HypothesisMucosal bacteria, including Enterobacteriaceae and Fusobacterium spp., are abundant in intestinal biopsies of cats with small cell GI LSA compared to cats with IBD.AnimalsFourteen cats with IBD and 14 cats with small cell GI LSA.MethodsRetrospective case control study. A search of the medical records was performed to identify cats diagnosed with IBD and with GI LSA. Bacterial groups identified by FISH in GI biopsies were compared between cohorts and correlated to CD11b+ and NF‐κB expression.Results Fusobacterium spp. (median; IQR bacteria/region) were higher in cats with small cell GI LSA in ileal (527; 455.5 – 661.5; P = .046) and colonic (404.5; 328.8 – 455.5; P = .016) adherent mucus, and combined colonic compartments (free mucus, adherent mucus, attaching to epithelium) (8; 0 – 336; P = .017) compared to cats with IBD (ileum: 67; 31.5 – 259; colon: 142.5; 82.3 – 434.5; combined: 3; 0 – 34). Bacteroides spp. were higher in ileal adherent mucus (P = .036) and 3 combined ileal compartments (P = .034) of cats with small cell GI LSA. There were significant correlations between Fusobacterium spp. totals and CD11b+ cell (P = .009; rs .476) and NF‐κB expression (P = .004; rs .523).ConclusionsThe bacterial alterations appreciated might be influential in development of small cell GI LSA, and should drive further studies to elucidate the effects of microbial‐mediated inflammation on GI cancer progression.

Evaluation of supervised machine-learning algorithms to distinguish between inflammatory bowel disease and alimentary lymphoma in cats.

Inflammatory bowel disease (IBD) and alimentary lymphoma (ALA) are common gastrointestinal diseases in cats. The very similar clinical signs and histopathologic features of these diseases make the distinction between them diagnostically challenging. We tested the use of supervised machine-learning algorithms to differentiate between the 2 diseases using data generated from noninvasive diagnostic tests. Three prediction models were developed using 3 machine-learning algorithms: naive Bayes, decision trees, and artificial neural networks. The models were trained and tested on data from complete blood count (CBC) and serum chemistry (SC) results for the following 3 groups of client-owned cats: normal, inflammatory bowel disease (IBD), or alimentary lymphoma (ALA). Naive Bayes and artificial neural networks achieved higher classification accuracy (sensitivities of 70.8% and 69.2%, respectively) than the decision tree algorithm (63%, p < 0.0001). The areas under the receiver-operating characteristic curve for classifying cases into the 3 categories was 83% by naive Bayes, 79% by decision tree, and 82% by artificial neural networks. Prediction models using machine learning provided a method for distinguishing between ALA-IBD, ALA-normal, and IBD-normal. The naive Bayes and artificial neural networks classifiers used 10 and 4 of the CBC and SC variables, respectively, to outperform the C4.5 decision tree, which used 5 CBC and SC variables in classifying cats into the 3 classes. These models can provide another noninvasive diagnostic tool to assist clinicians with differentiating between IBD and ALA, and between diseased and nondiseased cats.

Identification of Mucosa-Invading and Intravascular Bacteria in Feline Small Intestinal Lymphoma

Persistent bacterial infections of the gastrointestinal mucosa are causally linked to gastric carcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma in people and laboratory animals. We examined the relationship of mucosa-associated bacteria to alimentary lymphoma in cats. Intestinal biopsies from 50 cats with alimentary lymphoma (small cell, n = 33; large cell, n = 17) and 38 controls without lymphoma (normal to minimal change on histopathology, n = 18; lymphocytic-plasmacytic enteritis, n = 20) were evaluated. The number and spatial distribution of bacteria (ie, in luminal cellular debris, villus-associated mucus, adherent to epithelium, mucosal invasion, intravascular, or serosal) were determined by fluorescence in situ hybridization with the eubacterial probe EUB-338. Mucosa-invasive bacteria were more frequently observed in cats with large cell lymphoma (82%, P ≤ .001) than in cats with small cell lymphoma (18%), normal to minimal change on histopathology, and lymphocytic-plasmacytic enteritis (3%). Intravascular bacteria were observed solely in large cell lymphoma (29%), and serosal colonization was more common in cats with large cell lymphoma (57%) than with small cell lymphoma (11%, P ≤ .01), normal to minimal change (8%, P ≤ .01), and lymphocytic-plasmacytic enteritis (6%, P ≤ .001). The high frequency of invasive bacteria within blood vessels and serosa of cats with large cell lymphoma may account for the sepsis-related complications associated with large cell lymphoma and inform clinical management. Further studies are required to determine the role of intramucosal bacteria in the etiopathogenesis of feline alimentary lymphoma.

Oncologia veterinária – exames radiográficos e ultrassonografia na tomada de decisões

Imaging exams are frequently requested during assessment of oncological patients. Although advanced imaging techniques are already available in veterinary medicine, radiographic and ultrasonographic exams remain the basic diagnostic tools in veterinary oncology. This review describes some considerations to improve clinical approach to animals with neoplastic lesions based on the use of radiographic and ultrasonographic exams. The role of these modalities in screening, diagnosis, staging, treatment choice, and follow-up of cancers is discussed. Additionally, a workflow for some type of tumors is described, such as mediastinal lymphoma in cats, as well as mast cell tumors and osteosarcoma in dogs. Situations that require other techniques are also discussed.

Cutaneous Lymphoma at Injection Sites: Pathological, Immunophenotypical, and Molecular Characterization in 17 Cats.

Feline primary cutaneous lymphomas (FPCLs) account for 0.2% to 3% of all lymphomas in cats and are more frequently dermal nonepitheliotropic small T-cell tumors. Emergence of FPCL seems unrelated to feline leukemia virus (FeLV) serological positivity or to skin inflammation. A total of 17 cutaneous lymphomas with a history of vaccine injection at the site of tumor development were selected from 47 FPCLs. Clinical presentation, histology, immunophenotype, FeLV p27 and gp70 expression, and clonality were assessed. A majority of male (12/17), domestic short-haired (13/17) cats with a mean age of 11.3 years was reported. Postinjection time of development ranged from 15 days to approximately 9 years in 5 cats. At diagnosis, 11 of 17 cats had no evidence of internal disease. Lymphomas developed in interscapular (8/17), thoracic (8/17), and flank (1/17) cutaneous regions; lacked epitheliotropism; and were characterized by necrosis (16/17), angiocentricity (13/17), angioinvasion (9/17), angiodestruction (8/17), and peripheral inflammation composed of lymphoid aggregates (14/17). FeLV gp70 and/or p27 proteins were expressed in 10 of 17 tumors. By means of World Health Organization classification, immunophenotype, and clonality, the lesions were categorized as large B-cell lymphoma (11/17), anaplastic large T-cell lymphoma (3/17), natural killer cell-like (1/17) lymphoma, or peripheral T-cell lymphoma (1/17). Lineage remained uncertain in 1 case. Cutaneous lymphomas at injection sites (CLIS) shared some clinical and pathological features with feline injection site sarcomas and with lymphomas developing in the setting of subacute to chronic inflammation reported in human beings. Persistent inflammation induced by the injection and by reactivation of FeLV expression may have contributed to emergence of CLIS.

Large granular lymphoma in six cats.

Large granular lymphomas (LGLs) comprise a specific group of lymphomas regardless of classifi- cation scheme. An LGL consists of cells that show less or more mature morphology, but typically neoplastic cells possess cytoplasmic azurophilic granules clearly visible during cytological examin- ation. The aim of the present study was to present clinical and cytological data on large granular lymphomas in cats and to analyses the therapeutic responses in treated cases. During the period from 2012 to 2014 six cats were as having large granular lymphoma. In one cat a nasal form of LGL was recognized, a systemic form was recognized in another cat, and in four cases an alimentary form was recognized. Cellular samples for cytopathology were collected from the cat with nasal cavity mass, from the enlarged mandibular lymph node and thoracic cavity from second cat, and in four cats from the abdominal mass during ultrasound-assisted fine-needle biopsy. Therapy was introduced in 5 of the 6 cats. In two cases palliative therapy with glucocorticoids was conducted, in two cases chemotherapy with COP protocol, and therapy with masitinib in one case. The median of survival time for cats treated with anticancer therapy was 9 months, the median of survival time for cats treated with glucocorticoids was 1.5 months. In conclusion, large granular lymphomas, especially the alimentary form, are a relatively common type of lymphoma in cats. Simple diagnostic methods such as clinical examination, imaging techniques and routine cytology are sufficient in majority of cases. Despite aggressive behavior and poor general prognosis, conventional chemotherapy lead to a good response in some treated cats regardless of anatomic form and histologic grade of malignancy.

Cutaneous lymphoma of the tarsus in cats: 23 cases (2000-2012).

To determine features of lymphoma of the tarsus in cats. Multi-institutional retrospective study. 23 cats with cutaneous lymphoma of the tarsus. Veterinary oncologists were requested to submit cases fitting the following criteria: histologically or cytologically confirmed lymphoma with a location at or near the tarsus and described as subcutaneous or mass-like. Data regarding breed, sex, age, FeLV and FIV status, and reason for evaluation were collected. Results of staging tests, location of the tumor, immunophenotype, and histopathologic description were recorded. Type of treatments, outcome, survival time, presence or absence of progressive disease, and cause of death or reason for euthanasia were also recorded. Most cats were older, with a median age of 12 years (range, 7 to 18 years). No association with positive retroviral status was found. Popliteal lymph node involvement at diagnosis was reported in 5 cats, and a suspicion of lymphoma at a different site on the basis of results of abdominal ultrasonography was reported in 4 cats. Treatments were variable and included corticosteroids alone (n = 2), chemotherapy (9), radiation and chemotherapy (7), or surgery with or without chemotherapy (5). Thirteen cats were reported to have lymphoma at a different site at the time of last follow-up, death, or euthanasia. Median survival time for all cats in the study was 190 days (range, 17 to 1,011 days). Results suggested that tarsal lymphoma is an uncommon manifestation of lymphoma in cats, and in this study was most commonly nonepitheliotropic and of high grade as determined on histologic evaluation. Systemic involvement was identified; therefore, thorough staging is recommended prior to initiating treatment. Future studies are warranted to evaluate effective treatment protocols.

Prognostic Analyses on Anatomical and Morphological Classification of Feline Lymphoma

ABSTRACTThe present study was carried out to analyze the prognosis of 163 cats with lymphoma classified anatomically and cytomorphologically. Anatomically, alimentary lymphoma was the most common form and showed significantly shorter survival than mediastinal and nasal lymphomas in cats. Cytomorphologically, there was no predominant subtype in feline lymphomas. Immunoblastic type (18%), centroblastic type (16%), globule leukocyte type (15%), lymphocytic type (12%), lymphoblastic type (12%), pleomorphic medium and large cell type (10%) and anaplastic large cell type (7%) were relatively common subtypes. Most of the cats with globule leukocyte lymphoma had the alimentary form. Comparing median survival time among classifications, cats with globule leukocyte lymphoma showed significantly shorter survival than those with high-grade and other low-grade lymphomas. Furthermore, cats with high-grade lymphomas showed significantly shorter survival than cats with other low-grade lymphomas. The present study indicated the clinical significance of anatomical and cytomorphological evaluation in feline lymphomas.

Feline nasal lymphoma

ABSTRACT:This article visits the subject of nasal lymphoma in cats, its incidence, presenting signs, treatment options and nursing care. Lymphosarcoma, or lymphoma, is a systemic, round cell cancer, which arises from lymphoid tissues. Whilst multicentric lymphoma is more commonly diagnosed in dogs, it is more usual for cats to present with a specific anatomical site affected. Lymphoma is the most commonly diagnosed cancer in the nasal cavity, although nasal lymphoma is a relatively uncommon tumour. Nasal lymphoma is termed an extranodal lymphoma, commonly affecting older cats, and representing 5 – 10% of anatomic-specific lymphoma cases. Presenting signs are a consequence of the anatomical location of the tumour and its local effects. Diagnostics for nasal lymphoma follow a stepwise approach to initially establish a general health profile of the individual patient, as well as more specific modalities, including advanced imaging. A variety of treatment options may be employed and will depend on the grade and stage of the tumour, as well as any patient-specific factors. Nursing care of these patients may involve assistance with diagnostics, administration of prescribed treatments, comfort management, nutritional planning and/or assisted feeding and providing owner advice/support.

Extranodal lymphoma in the cat: prognostic factors and treatment options.

The majority of feline lymphoma is extranodal. While the gastrointestinal (GI) tract is the most commonly affected site, non-GI extranodal lymphomas, which are the focus of this review, account for a large proportion of lymphomas in cats. This article discusses prognostic factors for the most common of these extranodal lymphomas, both in general terms and specifically for individual sites. Prognostic factors remain poorly defined for feline lymphoma. Many cats with extranodal lymphoma have stage I disease at an accessible site. A major question for patients with apparently localised extranodal lymphoma is whether the tumour can be treated with localised therapy alone or requires systemic treatment as well. Again there is often no specific information available for a particular site, such as a localised intramuscular lymphoma. Instead, reliance must be placed on careful patient staging, particularly if local therapy alone is planned. Until such time as further studies looking at stage, anatomic site, histological grade and immunophenotype are available to assist treatment decision making for an individual cat with extranodal lymphoma, it seems reasonable to draw inferences from other common extranodal sites for which more specific information exists, such as nasal lymphoma.

Lymphoma in cats treated with a weekly cyclophosphamide-, vincristine-, and prednisone-based protocol: 114 cases (1998–2008)

To evaluate the clinical response rate, progression-free survival time, overall survival time, and possible prognostic factors associated with a cyclophosphamide-, vincristine-, and prednisone (COP)-based chemotherapy protocol in cats with lymphoma. Retrospective case series. 114 cats with lymphoma. Medical records of cats receiving a weekly COP-based chemotherapy protocol from 1998 to 2008 at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania were evaluated for information regarding signalment, anatomic site of involvement, cell morphology, treatment, and outcome. Retroviral status, baseline weight, substage, anatomic location, dose delays, dose reductions, and response to treatment were evaluated for prognostic importance. The majority of cases (94 [82.4%]) were substage b, and the most common anatomic site was the gastrointestinal tract (57 [50%]). Clinical response rate after the first chemotherapy cycle was 47.4%. Response to treatment was significantly associated with progression-free survival time and overall survival time, whereas substage was significantly associated with progression-free survival time. The median progression-free survival time and overall survival time were 65.5 and 108 days, respectively. Compared with nonresponders, responders had significantly longer median progression-free survival time (364 vs 31 days) and median overall survival time (591 vs 73 days). Clinical response after 1 cycle of COP-based chemotherapy was predictive for progression-free survival time and overall survival time in cats with lymphoma; therefore, response after 1 cycle of chemotherapy could be used to guide decisions about further treatment. No new prognostic factors were identified.

Prospective Clinical Trial to Compare Vincristine and Vinblastine in aCOP‐Based Protocol for Lymphoma in Cats

Current standard chemotherapy protocols for lymphoma in cats carry risks of gastrointestinal toxicity, which can decrease quality of life and complicate response assessment. Protocols with less gastrointestinal toxicity may improve treatment tolerance. The study purpose was to compare response rate, outcome, and toxicity between cats that received vincristine or vinblastine as part of combination chemotherapy for lymphoma. We hypothesized that vinblastine would have similar efficacy, but less gastrointestinal toxicity, compared with vincristine. Forty client-owned cats with confirmed diagnosis of lymphoma. Cats were randomized to 1 of 2 treatment arms and received weekly COP-based chemotherapy for 6 months or until disease progression. Response rate, progression-free survival (PFS), lymphoma-specific survival (LSS), and incidence and severity of gastrointestinal and hematologic toxicity were compared between arms. Arm cross-over occurred if specific gastrointestinal toxicity criteria were noted. Cats in both arms had similar response rates, PFS, and LSS (48 versus 64 days, P = .87; 139 versus 136 days, P = .96). Cats that received vincristine were significantly more likely to switch arms based on gastrointestinal toxicity than cats that received vinblastine (44.4 versus 10.5%, P = .02). Lower baseline weight was significantly negatively associated with PFS and LSS (P = .01, P = .003, respectively). Baseline anemia was significantly negatively associated with LSS (P = .04). Results suggest that vinblastine is a reasonable alternative to vincristine in the treatment of some cats with lymphoma. Baseline body weight remains a significant prognostic factor for cats with lymphoma.

Feline leukaemia virus: Half a century since its discovery

In the early 1960s, Professor William (Bill) F.H. Jarrett was presented with a time-space cluster of cats with lymphoma identified by a local veterinary practitioner, Harry Pfaff, and carried out experiments to find if the condition might be caused by a virus, similar to lymphomas noted previously in poultry and mice. In 1964, the transmission of lymphoma in cats and the presence of virus-like particles that resembled 'the virus of murine leukaemias' in the induced tumours were reported in Nature. These seminal studies initiated research on feline leukaemia virus (FeLV) and launched the field of feline retrovirology. This review article considers the way in which some of the key early observations made by Bill Jarrett and his coworkers have developed in subsequent years and discusses progress that has been made in the field since FeLV was first discovered.

The usefulness of immunohistochemistry to differentiate between nasal carcinoma and lymphoma in cats: 140 cases (1986–2000)

A retrospective evaluation of 232 feline nasal biopsies initially diagnosed as either carcinoma or lymphoma was performed by two pathologists. One or both pathologists disagreed with the original diagnosis in 15 cases (7%), 14 of which had original diagnoses of carcinoma. Out of the 232 cases, 140, including the disputed ones, were subjected to immunohistochemical staining with epithelial and lymphoid markers. Immunohistochemical staining of the 15 disputed cases showed that the original diagnoses were incorrect in 67% (10/15), unverified in 13% (2/15) and correct in 20% (3/15). Among the consensual diagnoses, immunohistochemistry revealed that 3% (4/125) of diagnoses were unverified because they did not stain for any of the markers evaluated. This report demonstrates the importance of immunohistochemistry in establishing a correct histologic diagnosis for nasal neoplasms in cats.

Utility of Endoscopic Biopsies of the Duodenum and Ileum for Diagnosis of Inflammatory Bowel Disease and Small Cell Lymphoma in Cats

Endoscopic duodenal biopsies are relatively convenient, minimally invasive tests for infiltrative intestinal disorders of cats. Ileal endoscopic biopsies might not be performed because of technical difficulty and effort required to prepare the colon. It is not known whether or not histopathology of feline duodenal and ileal biopsies for detection of inflammatory bowel disease (IBD) and small cell lymphoma (SC-LSA) provides comparable results. To evaluate the agreement between endoscopic biopsies of duodenum and ileum in cats with IBD and SC-LSA. Seventy client-owned cats with gastrointestinal disease and adequate duodenal and ileal tissue biopsies obtained endoscopically. Retrospective study: Search of medical records of cats with enteropathy and endoscopy. Samples were blinded and re-evaluated by single pathologist (JM) for quality, number of biopsies, and diagnosis according to WSAVA standards. Agreement of IBD and SC-LSA diagnoses among biopsy sites assessed using Cohen's Kappa. Eighteen of 70 cats (26%) were diagnosed with SC-LSA in duodenum, ileum, or both. Of these 18 cats, 7 (39%) were diagnosed with only duodenal SC-LSA, 8 (44%) were diagnosed with only ileal SC-LSA, and 3 (17%) had SC-LSA in both duodenum and ileum. There was poor agreement on diagnosis between duodenal and ileal biopsies (kappa = 0.23). Although review by a single pathologist remains a limitation of this study, results suggest that there is a population of cats in which diagnosis of SC-LSA can be found only by evaluation of ileal biopsies. Clinicians should consider performing both upper and lower GI endoscopic biopsies in cats with infiltrative small bowel disease.

Diagnostic Algorithm to Differentiate Lymphoma From Inflammation in Feline Small Intestinal Biopsy Samples

Differentiating between inflammatory bowel disease (IBD) and small intestinal lymphoma in cats is often difficult, especially when only endoscopic biopsy specimens are available for evaluation. However, a correct diagnosis is imperative for proper treatment and prognosis. A retrospective study was performed using surgical and endoscopic intestinal biopsy specimens from 63 cats with a history of chronic diarrhea or vomiting or weight loss. A diagnosis of lymphoma or inflammation was based on microscopic examination of hematoxylin and eosin (HE)-stained sections alone, HE-stained sections plus results of immunohistochemical labeling (IHC) for CD3e and CD79a, and HE staining, immunophenotyping, and polymerase chain reaction (PCR) results for B and/or T cell clonality. In addition, various histomorphologic parameters were evaluated for significant differences between lymphoma and IBD using Fisher's exact test. The sensitivity and specificity of each parameter in the diagnosis of lymphoma were also determined. Results of Bayesian statistical analysis demonstrated that combining histologic evaluation of small intestinal biopsy specimens with immunophenotyping and analysis of clonality of lymphoid infiltrates results in more accurate differentiation of neoplastic versus inflammatory lymphocytes. Important histologic features that differentiated intestinal lymphoma from IBD included lymphoid infiltration of the intestinal wall beyond the mucosa, epitheliotropism (especially intraepithelial nests and plaques), heterogeneity, and nuclear size of lymphocytes. Based on the results of this study, a stepwise diagnostic algorithm that first uses histologic assessment, followed by immunophenotyping and then PCR to determine clonality of the lymphocytes, was developed to more accurately differentiate between intestinal lymphoma and IBD.

Histopathologic classification of 171 cases of canine and feline non-Hodgkin lymphoma according to the WHO

A retrospective collection of 171 lymphoid neoplasms (123 dogs and 48 cats) was classified according to the Revised European-American Lymphoma (REAL) classification, adopted in 2002 by the World Health Organization (WHO), to evaluate the WHO system for categorization of canine and feline neoplasms. Microscopic examination was performed after standard hematoxylin-eosin staining and immunohistochemical labelling for B (CD79a) or T (CD3) cell phenotypes. B-cell lymphomas were prevalent in dogs and T-cell lymphomas in cats. B-Large cell lymphoma (B-LCL) frequently showed plasmacytoid differentiation; notably, two canine plasma cell tumours (PCT) expressed both CD79 and CD3. There were difficulties in differentiating B-lymphoblastic lymphoma (B-LBL) from Burkitt-type lymphoma. Furthermore, intestinal T-cell lymphoma (ITCL) exhibited a huge morphologic variability. Finally, multicentric mature small and thymic T-cell lymphomas were diagnosed, although these categories are not codified by the WHO classification.

Sézary Syndrome in a Cat

Sézary syndrome is an uncommon leukemic variant of cutaneous lymphoma in cats. This cat had recurrent dermatitis with erythematous, pruritic plaques. Multiple skin imprints and biopsy samples were obtained over a 6-month period, and histopathological findings were consistent initially with eosinophilic miliary dermatitis and later with erythema multiforme. One week before death, Sézary cells were identified in the peripheral blood that expressed cluster of differentiation (CD)3 and CD8 antigens. Massive infiltration of CD3+ lymphocytes was noted in the skin and multiple internal tissues by histopathological examination. This case demonstrates the difficulty in diagnosing cutaneous lymphoma early in the disease course.

Efficacy and Toxicosis of VELCAP‐C Treatment of Lymphoma in Cats

Lymphoma is the most common malignancy affecting cats. A protocol employing vincristine, l-asparaginase, cyclophosphamide, doxorubicin, and prednisone (VELCAP-S) is effective and well tolerated in dogs with lymphoma. A 24-week variation of this protocol (VELCAP-C) was developed for treatment of cats. That VELCAP-C will result in survival times for cats with lymphoma that are similar to those obtained when cats are treated with a protocol that includes fewer chemotherapy agents. Sixty-one cats with lymphoma. Retrospective study. Outcomes evaluated were response to VELCAP-C therapy, toxicosis, and survival time. The effect of signalment, staging, CBC, and serum chemistry profile and dosage on these outcomes was examined. Six cats (10%) completed the protocol with a median survival of 1189 days. Forty-three percent (23 of 61) of the cats achieved complete response (CR) with a median survival time of 62 days. Cats that required a dose reduction of any drug during induction were more likely to achieve CR. Weight loss and hepatomegaly at diagnosis were negatively associated with response to treatment. Increased lactate dehydrogenase (LDH) serum activity at the time of initial treatment correlated with decreased survival times. This multi agent protocol did not provide improved survival over historical data using protocols with fewer agents. Serum LDH activity levels might provide useful prognostic information for cats with lymphoma.