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Retrospective evaluation of thrombocytopenia and tumor stage as prognostic indicators in dogs with splenic hemangiosarcoma

Alison R. MasyrDepartment of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, MN 55108.
Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Aaron K. RendahlDepartment of Veterinary and Biomedical Sciences, University of Minnesota, Saint Paul, MN 55108.

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Amber L. WinterDepartment of Clinical Investigation Center, University of Minnesota, Saint Paul, MN 55108.
Department of College of Veterinary Medicine, and Animal Cancer Care and Research Program, University of Minnesota, Saint Paul, MN 55108.

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Antonella BorgattiDepartment of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, MN 55108.
Department of Clinical Investigation Center, University of Minnesota, Saint Paul, MN 55108.
Department of College of Veterinary Medicine, and Animal Cancer Care and Research Program, University of Minnesota, Saint Paul, MN 55108.
Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455.

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Jaime F. ModianoDepartment of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, MN 55108.
Department of College of Veterinary Medicine, and Animal Cancer Care and Research Program, University of Minnesota, Saint Paul, MN 55108.
Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455.
Stem Cell Institute, University of Minnesota, Minneapolis, MN 55455.
Center for Immunology, University of Minnesota, Minneapolis, MN 55455.
Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN 55455.

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Abstract

OBJECTIVE

To identify physical examination and perioperative CBC variables in dogs with splenic hemangiosarcoma (HSA) that could aid in predicting progression-free interval (PFI) and overall survival time (OST) in affected dogs.

ANIMALS

70 client-owned dogs with splenic HSA treated with splenectomy and chemotherapy between September 2004 and October 2016.

PROCEDURES

A retrospective search of the University of Minnesota Veterinary Medical Center medical records database was performed to identify dogs with splenic HSA treated with splenectomy and with evidence in the medical records of intent to treat with chemotherapy. Data collection included dog signalment and body surface area, results from CBCs performed within 6 days before to 2 days after splenectomy, whether dogs had hemoabdomen or received transfusions, and tumor stage. Hematocrit, WBC count, and platelet count were treated as categorical variables (divided into terciles: above, within, or below reference limits) because of variation among reference intervals for the numerous analyzers used. Associations between variables and PFI or OST were investigated with Cox regression analyses, and hazard ratios (HRs) for a shorter PFI or OST were reported. Population Pearson correlation coefficient (ρ) analysis was performed to identify potential associations between variables of interest.

RESULTS

Stage 3 HSA was identified as a negative prognostic indicator of PFI (HR, 6.6) and OST (HR, 4.5). Perioperative thrombocytopenia was similarly associated with shorter PFI (HR, 2.2) and OST (HR, 2.0). Results for Hct correlated (ρ = 0.58) with those for platelet count, and although our findings did not indicate a notable association between anemia and shorter PFI, such could not be ruled out.

CONCLUSIONS AND CLINICAL RELEVANCE

The prognostic value of thrombocytopenia warrants further substantiation to understand causal and mechanistic connections, and the presence of thrombocytopenia ultimately may prove valuable in guiding treatment recommendations for dogs with splenic HSA.

Abstract

OBJECTIVE

To identify physical examination and perioperative CBC variables in dogs with splenic hemangiosarcoma (HSA) that could aid in predicting progression-free interval (PFI) and overall survival time (OST) in affected dogs.

ANIMALS

70 client-owned dogs with splenic HSA treated with splenectomy and chemotherapy between September 2004 and October 2016.

PROCEDURES

A retrospective search of the University of Minnesota Veterinary Medical Center medical records database was performed to identify dogs with splenic HSA treated with splenectomy and with evidence in the medical records of intent to treat with chemotherapy. Data collection included dog signalment and body surface area, results from CBCs performed within 6 days before to 2 days after splenectomy, whether dogs had hemoabdomen or received transfusions, and tumor stage. Hematocrit, WBC count, and platelet count were treated as categorical variables (divided into terciles: above, within, or below reference limits) because of variation among reference intervals for the numerous analyzers used. Associations between variables and PFI or OST were investigated with Cox regression analyses, and hazard ratios (HRs) for a shorter PFI or OST were reported. Population Pearson correlation coefficient (ρ) analysis was performed to identify potential associations between variables of interest.

RESULTS

Stage 3 HSA was identified as a negative prognostic indicator of PFI (HR, 6.6) and OST (HR, 4.5). Perioperative thrombocytopenia was similarly associated with shorter PFI (HR, 2.2) and OST (HR, 2.0). Results for Hct correlated (ρ = 0.58) with those for platelet count, and although our findings did not indicate a notable association between anemia and shorter PFI, such could not be ruled out.

CONCLUSIONS AND CLINICAL RELEVANCE

The prognostic value of thrombocytopenia warrants further substantiation to understand causal and mechanistic connections, and the presence of thrombocytopenia ultimately may prove valuable in guiding treatment recommendations for dogs with splenic HSA.

Contributor Notes

Address correspondence to Dr. Masyr (masyr2@illinois.edu).