title: Combination chemotherapy with L-asparaginase, lomustine, and prednisone for relapsed or refractory canine lymphoma.
abstract: BACKGROUND
  Canine lymphoma (LSA) is responsive to initial treatment, however, it then becomes resistant to drugs in the initial protocol. New rescue protocols are needed.
  
  
  OBJECTIVE
  A combination of L-asparaginase, lomustine, and prednisone will be well tolerated and efficacious as a rescue therapy for dogs with LSA.
  
  
  METHODS
  Thirty-one client owned dogs with cytologically confirmed multicentric LSA who were refractory or whose disease had relapsed after a CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone)-based chemotherapy protocol.
  
  
  METHODS
  Prospective clinical trial. Lomustine (target dose, 70 mg/m2) was administered orally at 3-week intervals for a total of 5 doses or until disease progression. L-asparaginase (400 U/kg) was administered subcutaneously concurrently with the first 2 lomustine treatments. Prednisone was administered at a tapering dose for the duration of the protocol.
  
  
  RESULTS
  Overall response rate for dogs treated with this protocol was 87% (27/31), with 52% (16/31) of dogs achieving a complete response. Median time to response was 21 days. Median time to progression was 63 days (111 days for dogs achieving a complete response and 42 days for dogs achieving a partial response). There were no significant differences in response rates and times to progression between dogs who had received L-asparaginase before beginning this rescue protocol and those who had not. Toxicoses were mild and self-limiting in 29 of 31 cases.
  
  
  CONCLUSIONS
  This is a well-tolerated rescue therapy for relapsing LSA in dogs. Response rates and remission durations compare favorably to other rescue protocols. Therefore, this protocol is a viable rescue option.
authors.affiliation: Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison 53706, USA.
authors.forename: Corey F
authors.initials: CF
authors.lastname: Saba
authors.forename: Douglas H
authors.initials: DH
authors.lastname: Thamm
authors.forename: David M
authors.initials: DM
authors.lastname: Vail
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols; D001215:Asparaginase / Q000627:therapeutic use*; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D019008:Drug Resistance, Neoplasm; D005260:Female; D008130:Lomustine / Q000627:therapeutic use*; D008223:Lymphoma / Q000188:drug therapy / Q000662:veterinary*; D008297:Male; D011241:Prednisone / Q000627:therapeutic use*; D012008:Recurrence; D013997:Time Factors
chemical_list: D008130:Lomustine; D001215:Asparaginase; D011241:Prednisone