Page 1296 - Clinical Small Animal Internal Medicine

1234 Section 11 Oncologic Disease

Table 134.2 UW‐Madison short CHOP lymphoma protocol
VetBooks.ir Treatment week Drug, dosage, and route

2
1 Baseline CBC/chemistry profile/UA Vincristine (0.5–0.7 mg/M ) IV
Prednisone 2 mg/kg once per day for 7 days
2
2 Pretreatment CBC/plt Cyclophosphamide (250 mg/M ) IV or PO a
Prednisone 1.5 mg/kg once per day for 7 days
2
3 Pretreatment CBC/plt Vincristine (0.5–0.7 mg/M ) IV
Prednisone 1 mg/kg once per day for 7 days
2
4 Pretreatment CBC/plt Doxorubicin (30 mg/M ) IV +
Prednisone 0.5 mg/kg once per day for 7 days then discontinue
5 No treatment: consider restaging to assess for response to treatment b
2
6 Pretreatment CBC/plt Vincristine (0.5–0.7 mg/M ) IV
2
7 Pretreatment CBC/plt Cyclophosphamide (250 mg/M ) IV or PO a
2
8 Pretreatment CBC/plt Vincristine (0.5–0.7 mg/M ) IV
2
9 Pretreatment CBC/plt Doxorubicin (30 mg/M ) IV
10 No treatment
2
11 Pretreatment CBC/plt Vincristine (0.5–0.7 mg/M ) IV
2
12 Pretreatment CBC/plt Cyclophosphamide (250 mg/M ) IV or PO a
2
13 Pretreatment CBC/plt Vincristine (0.5–0.7 mg/M ) IV
2
14 Pretreatment CBC/plt Doxorubicin (30 mg/M ) IV c
15 No treatment
2
16 Pretreatment CBC/plt Vincristine (0.5–0.7 mg/M ) IV
2
17 Pretreatment CBC/plt Cyclophosphamide (250 mg/M ) IV or PO a
2
18 Pretreatment CBC/plt Vincristine (0.5–0.7 mg/M ) IV
2
19 Pretreatment CBC/plt Doxorubicin (30 mg/M ) IV d
a Administer with furosemide 2 mg/kg SC to prevent sterile hemorrhagic cystitis (SHC). Substitute with chlorambucil at 1.4 mg/kg
if SHC develops.
b Reduce dose to 1 mg/kg for dogs <15 kg.
2
c Do not exceed 180 mg/M maximum cumulative dose.
d If progressive disease is noted at any point in the treatment protocol, rescue chemotherapy should be considered.
CBC, complete blood count; IV, intravenous; plt, platelets; PO, by mouth (per os); UA, urine analysis.

If multiagent therapy is not an option, it is reasonable to multiagent therapy from the outset, are more likely to
incorporate any number of the CHOP drugs and create develop multidrug resistance and experience shorter
an individual protocol that suits the dog and the owner. remission and survival times if any subsequent chemo­
Doxorubicin as a single agent, administered every 2–3 therapy is administered.
weeks (up to five total treatments), can induce a remis­
sion in 50–75% of dogs for a median of 6–8 months. Care Reinduction Chemotherapy Protocols
must be taken to monitor for cumulative cardiotoxic Reinduction with CHOP‐based drugs is recommended
effects of this drug in the dog, which can result in dilated provided that the recurrence is temporally far enough
cardiomyopathy (DCM). It is advisable to avoid this drug from the conclusion of the initial protocol (i.e., ≥ 2
in dogs with a preexisting heart condition or breeds that months). Typically, a second or even third remission is
are considered high risk for DCM (e.g., boxer, Doberman achievable with a variable duration of response.
pinscher, Great Dane, etc.). Other protocols with similar
success include cyclophosphamide, vincristine, and Rescue Chemotherapy
prednisone (referred to as COP). Inevitably, resistance to the CHOP‐based chemotherapy
Dogs which are treated with a palliative protocol of drugs will develop, and it is unlikely that continued use
prednisone as a sole therapy can achieve a short‐lived of the same drugs will provide a significant benefit. At
remission of approximately 1–2 months. It is important that point, drugs not used in the initial CHOP proto­
to note that these dogs, when compared to dogs given cols are recommended and are referred to as rescue