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Lymphoma Chemotherapy Treatment Tables, Dog 603

COP Protocol (Cat)
VetBooks.ir Treatment and Week Week Week Week Week Week Week Week Week Week Weeks 13, † Diseases and Disorders
7
6
10
9
8
5
2
1*
3
Monitoring
4
16, 19, etc.
•
•
CBC
‡
•
•
•
•
•
Cyclophosphamide § • • • • •
Vincristine ¶ • • • • • • •
Prednisolone • • • • • • • • • • •
*Day of first treatment.
† Continue 3-week cycle until relapse or until week 26 (Moore et al) or week 52 (Teske et al).
‡ Complete blood count (CBC) once weekly for first 3-week treatment cycle, then every 3 weeks thereafter to screen for cytopenias, which could postpone or reduce treatment(s):
Cyclophosphamide 300 mg/m PO q 3 weeks
2
2
Vincristine 0.75 mg/m IV once weekly × 4 weeks, then q 3 weeks thereafter
Prednisolone 40-50 mg/m PO q 24h
2
2
§ The cyclophosphamide dosage in this protocol may be too high for some cats, and it may be preferable to start at a dosage of 200-250 mg/m with subsequent consideration of escalation to 300 mg/m 2
if no toxicoses are noted.
2
¶ The vincristine dosage in this protocol may be too high for some cats, resulting in gastrointestinal toxicoses (e.g., ileus); a dosage of 0.5 mg/m may be preferable.
Data from Moore AS, et al: A comparison of doxorubicin and COP for maintenance of remission in cats with lymphoma. J Vet Intern Med 10(6):372-375, 1996; Teske E, et al: Chemotherapy with
cyclophosphamide, vincristine, and prednisolone (COP) in cats with malignant lymphoma: new results with an old protocol. J Vet Intern Med 16(2):179-186, 2002.
CHOP Protocol (Cat)
Treatment and
Monitoring Week 1* Week 2 Week 3 Week 4 Week 5 Week 6 † Week 7 † Week 8 † Week 9 † Week 10 †
CBC • • • • • • • •
L-Asparaginase •
Cyclophosphamide • •
Doxorubicin • •
Prednisolone • • • • • • • •
Vincristine • • • •
*Day of first treatment.
† Continue/repeat 5-week treatment course (vincristine, cyclophosphamide, vincristine, doxorubicin, off) for two additional cycles to complete 20-week treatment protocol:
L-Asparaginase 400 U/kg SQ; if L-asparaginase is not available, the protocol can proceed without the inclusion of this drug.
Cyclophosphamide 200-250 mg/m PO
2
Doxorubicin 25 mg/m or 1 mg/kg IV as slow infusion (20 min)
2
Prednisolone 2 mg/kg PO q 24h for weeks 1 and 2; then 1 mg/kg PO q 24h for weeks 3 and 4; then 1 mg/kg PO q 48h for weeks 5 and 6; then taper and discontinue
Vincristine 0.5 mg/m IV
2
CBC, Complete blood count.
Lymphoma Chemotherapy Treatment Tables, Dog Client Education
Sheet
CBC Monitoring Guidelines for care and diagnostic testing if animal is overtly CBC in 3-7 days, and resume treatment
Dogs ill. when neutrophil count is > 2000 cells/mcL.
DOSAGE REDUCTION • If platelets < 50,000 cells/mcL on any CBC, • If platelets < 50,000 cells/mcL on day treat-
• If neutrophils < 1000 cells/mcL on any decrease dosage of causative agent by 25% ment is due, postpone treatment, recheck
CBC, decrease dosage of causative agent by for future treatments. CBC in 3-7 days, and resume treatment
25% for future treatments, begin empirical when platelet count is > 50,000 cells/mcL.
prophylactic antibiotics (e.g., amoxicillin- TREATMENT DELAY
clavulanate 11-22 mg/kg PO q 12h for 7 • If neutrophils < 2000 cells/mcL on day AUTHOR: Laurel E. Williams, DVM, DACVIM
EDITOR: Kenneth M. Rassnick, DVM, DACVIM
days), and consider additional supportive treatment is due, postpone treatment, recheck

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