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Evaluation of factors associated with second remission in dogs with lymphoma undergoing retreatment with a cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy protocol: 95 cases (2000–2007)

Andrea B. Flory DVM, DACVIM1, Kenneth M. Rassnick DVM, DACVIM2, Hollis N. Erb DVM, PhD3, Laura D. Garrett DVM, DACVIM4, Nicole C. Northrup DVM, DACVIM5, Kim A. Selting DVM, DACVIM6, Brenda S. Phillips DVM, DACVIM7, Jennifer E. Locke DVM, DACVIM8, and John D. Chretin DVM, DACVIM9
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  • 1 The Animal Medical Center, 510 E 62nd St, New York, NY 10065.
  • | 2 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.
  • | 3 Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.
  • | 4 Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.
  • | 5 Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.
  • | 6 Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211.
  • | 7 Veterinary Specialty Hospital of San Diego, 10435 Sorrento Valley Rd, San Diego, CA 92121.
  • | 8 Southeast Veterinary Oncology, 304 Corporate Way, Orange Park, FL 32073.
  • | 9 VCA West Los Angeles Animal Hospital, 1818 S Sepulveda Blvd, Los Angeles, CA 90025.

Abstract

Objective—To evaluate factors associated with second remission in dogs with lymphoma retreated with a cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) protocol after relapse following initial treatment with a first-line 6-month CHOP protocol.

Design—Retrospective case series.

Animals—95 dogs with lymphoma.

Procedures—Medical records were reviewed. Remission duration was estimated by use of the Kaplan-Meier method. Factors potentially associated with prognosis were examined.

Results—Median remission duration after the first-line CHOP protocol was 289 days (range, 150 to 1,457 days). Overall, 78% (95% confidence interval [CI], 69% to 86%) of dogs achieved a complete remission following retreatment, with a median second remission duration of 159 days (95% CI, 126 to 212 days). Duration of time off chemotherapy was associated with likelihood of response to retreatment; median time off chemotherapy was 140 days for dogs that achieved a complete remission after retreatment and 84 days for dogs that failed to respond to retreatment. Second remission duration was associated with remission duration after initial chemotherapy; median second remission duration for dogs with initial remission duration ≥ 289 days was 214 days (95% CI, 168 to 491 days), compared with 98 days (95% CI, 70 to 144 days) for dogs with initial remission duration < 289 days.

Conclusions and Clinical Relevance—Findings suggested that retreatment with the CHOP protocol can be effective in dogs with lymphoma that successfully complete an initial 6-month CHOP protocol.

Abstract

Objective—To evaluate factors associated with second remission in dogs with lymphoma retreated with a cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) protocol after relapse following initial treatment with a first-line 6-month CHOP protocol.

Design—Retrospective case series.

Animals—95 dogs with lymphoma.

Procedures—Medical records were reviewed. Remission duration was estimated by use of the Kaplan-Meier method. Factors potentially associated with prognosis were examined.

Results—Median remission duration after the first-line CHOP protocol was 289 days (range, 150 to 1,457 days). Overall, 78% (95% confidence interval [CI], 69% to 86%) of dogs achieved a complete remission following retreatment, with a median second remission duration of 159 days (95% CI, 126 to 212 days). Duration of time off chemotherapy was associated with likelihood of response to retreatment; median time off chemotherapy was 140 days for dogs that achieved a complete remission after retreatment and 84 days for dogs that failed to respond to retreatment. Second remission duration was associated with remission duration after initial chemotherapy; median second remission duration for dogs with initial remission duration ≥ 289 days was 214 days (95% CI, 168 to 491 days), compared with 98 days (95% CI, 70 to 144 days) for dogs with initial remission duration < 289 days.

Conclusions and Clinical Relevance—Findings suggested that retreatment with the CHOP protocol can be effective in dogs with lymphoma that successfully complete an initial 6-month CHOP protocol.

Contributor Notes

Dr. Flory's present address is Veterinary Specialty Hospital, 2055 Montiel Rd, San Marcos, CA 92069.

Dr. Rassnick's present address is Veterinary Medical Center of Central New York, 5841 Bridge St, Syracuse, NY 13057.

Presented in part at the 28th Annual Conference of the Veterinary Cancer Society, Seattle, October 2008.

Address correspondence to Dr. Flory (flory.andi@gmail.com).