title: Comparison of a CHOP-LAsp-based protocol with and without maintenance for canine multicentric lymphoma.
abstract: The recommendation to treat canine lymphoma with a discontinuous protocol is based on small case numbers and mostly historic controls. This study compares duration of first remission (DFR) and overall survival time (ST) with a discontinuous protocol to the same protocol with maintenance phase. 408 dogs were treated with a CHOP-LAsp (C=cyclophosphamide; H=hydroxydaunorubicin; O=Oncovin; P=prednisolone; LAsp=l-asparaginase)-based 28-week induction protocol. In 75 dogs (cohort 1), this was followed by a maintenance phase consisting of vincristine, chlorambucil and actinomycin-D with a total treatment duration of two years. In the subsequent 333 dogs, therapy was discontinued after induction (cohort 2). Median DFR and ST in cohort 1 were 216 and 375 days and 184 and 304 days in cohort 2. 6-Month, 1-year and 2-year survival rates in cohort 1 were 73 per cent, 50 per cent, 24 per cent and 67 per cent, 39 per cent, 21 per cent in cohort 2. There was no significant difference between the two protocols (P=0.291 for ST, P=0.071 for DFR). On multivariate analysis, corticosteroid pretreatment (P=0.005), thrombocytopenia at diagnosis (P=0.019), stage (P=0.009), substage b at relapse (P<0.001), age (P=0.002) and incomplete or unstable remission necessitating intensification of therapy (P=0.004) were negatively correlated with ST in both groups. This study supports the use of a discontinuous protocol for canine multicentric lymphoma.
authors.affiliation: Small Animal Clinic Hofheim, Katharina-Kemmler-Str. 7, Hofheim 65719, Germany.
authors.forename: E M
authors.initials: EM
authors.lastname: Lautscham
authors.affiliation: Small Animal Clinic Hofheim, Katharina-Kemmler-Str. 7, Hofheim 65719, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kessler
authors.affiliation: Small Animal Clinic Hofheim, Katharina-Kemmler-Str. 7, Hofheim 65719, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Ernst
authors.affiliation: Small Animal Clinic Hofheim, Katharina-Kemmler-Str. 7, Hofheim 65719, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Willimzig
authors.affiliation: Small Animal Clinic, Internal Medicine, Justus-Liebig-University Giessen, Frankfurter Str. 126, Giessen 35392, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Neiger
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols; D003520:Cyclophosphamide; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D004317:Doxorubicin; D005260:Female; D008223:Lymphoma / Q000188:drug therapy / Q000662:veterinary*; D008297:Male; D011241:Prednisone; D012189:Retrospective Studies; D016896:Treatment Outcome; D014750:Vincristine
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: CHOP-protocol; Chemotherapy; duration of first remission; multicentric lymphoma; survival time