Hematopoietic Tumors Flashcards
(246 cards)
1
Q
What was the overall MST in dogs w/ untreated, peripheral intermediate-large cell LSA treated with prednisone alone?
A
50 days
2
Q
____ and ____ were associated with survival time in dogs with untreated, peripheral intermediate - large cell LSA treated w/ prednisone alone.
A
Owner-perceived QOL scores and substage
3
Q
What was the PFS and ORR for naive & previously treated dogs with MC lymphoma treated with Tanovea? What was the PFS in placebo treated dogs?
A
Tanovea PFS was significantly longer than placebo (~3 months vs. 21 days)
ORR: 73% (CR 51%)
4
Q
What was the ORR and PFS in naive dogs w/ MC LSA treated with Tanovea +/- steroids (Thamm paper)?
A
ORR: 87% (CR 52%)
PFS: 4 months
5
Q
***In a retrospective study evaluating the diagnostic relevance of lymph node biopsy in cats with small cell intestinal lymphoma, ___% showed no nodal involvement and ____% of clonality tests correctly identified reactive lymph nodes.
A
70%
63%
6
Q
In a prospective clinical trial of dogs with diffuse, naive large B cell LSA treated with low dose doxorubicin and anti-CD20 monoclonal antibody (1E4-cIgGB), a significant depletion in ______ cells was seen 7 days post infusion. This depletion persisted for ____ months.
A
CD21+ B cells; 4+ months
7
Q
A retrospective study evaluating vincristine-induced side effects related to body weight in dogs treated for LSA found that vincristine dosed at ______ does not increase the risk of hematologic events in dogs weighing <15kg. Dogs treated at this dose has a ___ risk of neutropenia and ___% risk of GI AEs.
A
- 0.6mg/m2
- neutropenia: 12%
- GI AEs: 29%
8
Q
What was the overall MST reported in a retrospective study of 50 cats with MRD treated with various chemo protocols? What variables were associated with shorter outcomes? List the overall response rates to the following chemotherapy protocols:
a. melphalan + pred ____%
b. Cytoxan + pred ___%
c. Chlorambucil + pred ___%
Was the type of chemotherapy protocol significantly associated w/ survival? Adverse events to melphalan or cyclophosphamide occurred in ___% and __% of cats, respectively, in a retrospective study evaluating outcome in cats w/ MRD.
A
MST: 4mo
Anemia & thrombocytopenia
a. 87%
b. 90%
c. 100%
No
- melphalan AE - 65%
- Cytoxan AE - 23%
9
Q
In a retrospective study investigating the relationship b/w serum cortisol concentrations and chemotherapy outcome in dogs with lymphoma, the high COR group experienced a ________, ______, and _______. Although no significant differences were found in rate of _____ cells b/w groups, the rate of ____ cells was significantly lower in the high COR group
A
- significantly lower response to chemotherapy
- lower PFS
- lower MST
- Pgp+ cells
- Glucocorticoid receptor + cells
10
Q
In a retrospective study investigating the relationship b/w serum cortisol concentrations and chemotherapy outcome in dogs with lymphoma, although no significant differences were found in rate of _____ cells b/w groups, the rate of ____ cells was significantly lower in the high COR group.
A
- Pgp+ cells
- Glucocorticoid receptor + cells
11
Q
What was the ORR, PFS, and MST in a prospective cohort study in dogs with MC LSA that underwent dose-escalation 15-week CHOP.
A
ORR - 100%
PFS - 6mo
MST - 8.5mo
12
Q
In a prospective cohort study for dogs with MC LSA that underwent dose-escalation 15-week CHOP, for the dogs that were able to dose escalate, at least 1 drug was successfully escalated in ____%. ____% of the dogs that underwent dose escalation were hospitalized at least once due to AEs. The most common DLT of all dogs was ______________.
A
- 78%
- 13%
- Neutropenia
13
Q
In a prospective study of dogs with MC B cell LSA comparing those that received chemotherapy + half-body radiation to historical matched controls only receiving chemotherapy, the radiation cohort’s 2-year disease-free rate was _____% and the median remission was _____. The control group’s 2-year disease-free rate was ____% and the median remission was ____. The radiation cohort’s 2-year survival rate was ____% and the MST was ____. The control group’s 2-year survival rate was ___% and the MST was ____.
A
RT group:
- 56%
- exceeded 730-day study period
Control:
- 0%
- 9mo
RT group
- 78%
- MST: exceeded 730 day study period
Control:
- 11%
- MST: 9.5mo
14
Q
What was the MST reported in 11 dogs with suspected primary bone marrow T-cell lymphoid neoplasia causing hypercalcemia w/ treatments ranging from prednisone alone to multi-agent chemotherapy?
A
MST - 9mo
15
Q
A retrospective study evaluating pegylated-l-asparaginase mono therapy in 83 cats with large cell LSA found a response rate of ____% with ___% in CR. Median disease free period was _____ and OST was _____.
A
- RR: 74%
- CR 38%
- Disease free period: 2mo
- MST: 3mo
16
Q
In a retrospective study evaluating CMOP as first line treatment for 31 cats with intermediate - large cell LSA, the ORR was ____%, the CR rate was ____% and the PR rate _____%.
A
- ORR: 74%
- CR: 45%
- PR: 29%
17
Q
Retrospective evaluation of melphalan, vincristine, and cytarabine (MOC) novel multi-agent protocol in 26 dogs with relapsed multicentric LSA found an ORR ____% with ___% experiencing a CR. PFS was _____ and the overall clinical benefit was _____% for a median of ______.
A
- ORR: 38%
- CR: 19%
- PFS: 29 days
- clinical benefit: 65% w/ median of 37 days
18
Q
Treatment of feline intermediate to high grade alimentary LSA using a novel multi-agent chemotherapy protocol (VAPC: V: Vinblastine, A: doxorubicin; P: procarbazine; C: high-dose cytoxan; Elspar, prednisolone) +/- surgery was assessed in 55 cats. Of 38 cats receiving chemotherapy for measurable disease, ___% achieved a CR. For all cats, PFS was ____ and 1-year, 2-year, and 3-year survival rates were ____%, ____% and ____%, respectively. MST for CR cats was _____. PFS was significantly affected by ______ and _____.
A
- CR rate: 68%
- PFS: 6mo
- 1year survival rate: 35%
- 2 & 3 year survival rates: 25%
- CR MST: 11mo
- lymphocyte:monocyte ration >3.4 increased survival and B cell immunophenotype increased survival
19
Q
65 dogs with large granular lymphocyte lymphoma were evaluated. The most common breed was a _______. 32 dogs were treated with MTD chemotherapy w/ a response documented in ___%, PFI of ___, and MST of ____.
A
- response rate: 74%
- PFI: 17d
- MST: 28d
20
Q
A retrospective study out of France evaluating feline high-grade and large granular alimentary LSA treated with COP or CHOP (n=57) found a CR rate of ___%, PR rate of ___%, SD ___%, PD ___% for an ORR of ___%. PFI was ____ and OST was ____.
A
- CR: 20%
- PR: 22%
- SD: 36%
- PD: 22%
- ORR: 42%
- PFI: 5mo
- OST: 4mo
21
Q
A retrospective study out of Australia evaluated clinical response and prognostic factors in canine MC LSA treated w/ first rescue therapy (CHOP-like, CCNU-rich combo, Doxorubicin single-agent, CCNU single-agent). Median PFS was ____.
A
PFS: 2mo
22
Q
A prospective trial (Thamm) evaluating alternating Tanovea and doxorubicin treatment for naive canine lymphoma was recently performed in 59 dogs. ORR was ___% with CR rate of ____% and PR of ___%. PFS was _____.
A
- ORR: 93%
- CR: 79%
- PR: 14%
- PFS: 7mo
23
Q
A retrospective study evaluating use of lomustine and prednisolone as first-line treatment for dogs with MC LSA was performed. The ORR was ___% with a CR rate of ___% and PR rate of ___%. Median TTP, DFI, and MST were ____, _____, and ____, respectively. The only factor associated w/ DFI and MST was ______.
A
- ORR: 87%
- CR: 50%
- PR: 37%
- TTP: 42d
- DFI: 63d
- MST: 90d
- stage
24
Q
The efficacy of mirtazapine in reducing GI adverse effects was evaluated in 11 cats treated with doxorubicin in a placebo-controlled crossover study. The results demonstrated that mirtazapine can significantly increase _______, ______, and _______ and reduce ______ in cats after receiving doxorubicin.
A
- increase body weight, appetite, and activity
- reduce vomiting
25
What was the response rate (resolution of cytopenia) seen in a study of 11 dogs with myeloid neoplasia (MDS or AML) treated with concurrent Cytosar and doxorubicin? What was the median duration of remission in responders? What was the oMST? Three dogs developed grade V toxicity manifesting as _______ in 2 and ______ in 1.
- RR 64%
- duration of remission: 12 months
- oMST: 12 months
- heart failure = 2
- acute GI side effects = 1
26
What is the flow cytometry phenotype of an aggressive T-cell leukemia seen in young (median age 3 years) male English Bulldogs? What is the median lymphocyte count and their morphology? Bulldogs that received multi-agent chemotherapy had longer MST's (_______) than those with no treatment or less aggressive therapy.
- CD4- CD8- MHCII low
- 44k; small to intermediate
- MST w/ multiagent therapy: 3 months
27
A recent paper evaluating the clinical outcome and prognostic factors in dogs with B-CLL was performed. What was the oMST? What breed was associated with shorter survival time of _______? Cases with high Ki67 had a shorter MST (______) compared to those with low Ki67 (_______).
- oMST: 10 months
- Boxers; MST: 6 months
- High Ki67 (>40%) MST: 6 months
- Low Ki67 (<40%) MST: undetermined
28
Polyclonal B-cell lymphocytosis in English Bulldogs is characterized by ______ expression on flow cytometry, _________, and hyperglobulinemia with what immunoglobulin in most cases? What is the median age and sex predisposition of these dogs?
- low B-cell class MHCII and CD25
- splenomegaly
- IgA +/- IgM
- 6 years; male
29
A recent small study in 6 cats with ALL was performed. Of the 5 cats treated with cytotoxic therapy, ___% had partial remission. What was the oMST?
- 40%
- oMST: 2 months
30
***Minimal residual disease in dogs with multicentric lymphoma who achieved CR following therapy was assessed. What was the time to replase (TTR) in dogs with acellular samples, <0.5% infiltration, and >0.5% infiltration?
- TTR acellular samples: 6 months
- TTR <0.5% infiltration: not reached
- TTR >0.5% infiltration: 4 months
31
A recent study evaluating the outcome and prognostic factors in dogs with epitheliotropic and nonepitheliotropic was performed. The MST was significantly shorter in epitheliotropic dogs (______) compared to nonepitheliotropic (______).
- MST epitheliotropic: 5 months
- MST nonepitheliotropic: 13 months
32
32 dogs with large cell GI LSA were treated with weekly Elspar injections with a median number of 7 injections. What was the RR based on US and clinical signs, PFS, and MST? ___% developed hypersensitivity.
- RR US: 56%
- RR C/S: 94%
- PFS: 2 months
- MST: 5 months
- 0% developed hypersensitivity
33
Prognostic significance of peripheral blood and bone marrow infiltration in dogs with nodal marginal zone LSA was assessed. What was the TTP in dogs with peripheral blood infiltration <30% compared to >30%? What were the MST in dogs with BM infiltration <1%, 1-20%, and >20%?
- TTP <30% PB infiltration: 6 months
- TTP >30% PB infiltration: 1 month
- MST <1% BM infiltration: 47 months
- MST 1-20% BM infiltration: 11 months
- MST >20% BM infiltration: 6 months
34
A study evaluating outcome of dogs with primary high grade mediastinal LSA was performed. The PFS was ____ and the MST was _____. Dogs treated with _____ had improved outcome when compared to other therapies.
- PFS: 4 months
- MST: 6 months
- CHOP
35
A recent study evaluating diffuse small B cell LSA in dogs found a MST of _____.
5 months
36
A recent study evaluating outcome in dogs with nodal small B cell LSA treated with CHOP and Ki67 evaluation was performed. What was the PFS, MST, and RR?
- PFS: 2 months
- MST: 9 months
- RR: 50%
37
In a case control study of cats undergoing renal transplant, ___% developed cancer while on cyclosporine treatment with ___% being lymphoma.
24%
36%
38
What are some environmental and immunologic risk factors that have been implicated in the development of canine lymphoma?
- pesticide/2-4-D
- Tobacco smoke
- strong magnetic fields
- use of chemicals (paints/solvents)
- industrial areas
- near environment waste
- prior ITP
39
Hypercalcemia is reported to occur in ___-____% of dogs with lymphoma. ___% of dogs with lymphoma and hypercalcemia had the mediastinal form.
10-40%
43%
40
Diffuse pulmonary infiltration is seen in __-__% of dogs with multicentric lymphoma.
27-34%
41
Monoclonal gammopathies have been reported to occur in __% of dogs with lymphoma.
6%
42
CSF analysis was found to be diagnostic of lymphoma in ___% of samples.
74%
43
In one study of 53 dogs with lymphoma, __% had circulating malignant cells and were considered leukemic, whereas bone marrow examination indicated involvement in ___% of cases.
- 28%
- 57%
44
***Cranial mediastinal lymphadenopathy is detected in ___% of dogs with lymphoma. Sternal or tracheobronchial lymphdenopathy is seen in ___%.
20%
67%
45
***A group of 55 dogs with lymphoma treated with identical CHOP therapy was evaluated. What were the MSTs reported for dogs with CD3+ vs. CD3- lymphoma? For substage a vs. substage b?
MST CD3+: 5 months
MST CD3-: 13 months
MST substage a: 12 months
MST substage b: 2 months
46
***The expected CR rate for single-agent DOX for lymphoma in dogs ranges from ___-___% with an anticipated MST ranging from ____ - _____.
50-75%
6-8 months
47
***CCNU and prednisone for naive dogs with lymphoma is associated with a remission duration of _____ in a small case series.
1 month
48
Regarding biomarkers of minimal residual disease in dogs with lymphoma ______, _______, ______, ______ may be candidates.
- Thymidine kinase 1 activity
- Serum lactate dehydrogenase activity
- haptoglobin
- Serum C-reactive protein
49
Reinduction rates of ___-___% can be expected in dogs that have completed CHOP-based therapy.
80-90%
50
Rescue response rates in dogs with LSA are reported to be ___-___% with median response durations of ____- _____. <___% of dogs will enjoy longer response durations.
40-90%
1.5-2.5 months
20%
51
The ORR for DMAC as a rescue protocol for canine LSA ranges from ___-__% with a CR rate of ___-___%, respectively. The PFS was ____-___. The main toxicity of this protocol is ______, occurring in 40-55%
- RR: 43-72%
- CR: 16-44%
- PFS: 1-2mo
- thrombocytopenia
52
The ORR for single-agent lomustine as a rescue protocol for canine LSA is __% with a CR rate of ___%. The PFS is ____.
- RR: 27%
- CR: 7%
- PFS: 3mo
53
The ORR for lomustine, Elspar, and prednisone as a rescue protocol for canine LSA ranges from ____-___% with a CR rate of ___-___%, respectively. The PFS is ___.
- RR: 77-87%
- CR: 52-65%
- PFS: 2mo
54
The ORR for DTIC as a rescue for canine LSA is __% with a CR rate of ___%. The PFS was _____ and the median duration of CR was ____.
- RR: 35%
- CR: 3%
- PFS: 1mo
- PFS CR: 5 months
55
The ORR for DTIC or temozolomide-anthracycline as a rescue protocol for canine LSA is ___% with a CR rate of ___%. The median duration of remission was _____.
- RR: 71%
- CR: 55%
- PFS: 2 months
56
The ORR for lomustine + DTIC as a rescue protocol for canine LSA is ___% with a CR rate of ___%. The PFS was ____.
- RR: 35%
- CR: 23%
- PFS: 2mo
57
The ORR for mitoxantrone as a rescue protocol for canine LSA is ___% with a CR rate of ___%. The median duration of CR was _____.
- RR: 41%
- CR: 30%
- PFS CR: 4 months
58
The ORR for MOPP as a rescue protocol for canine LSA is ___% with a CR rate of ___%. The median duration of CR is ____.
- RR: 65%
- CR: 31%
- PFS: 2 months
59
The ORR for MPP as a rescue protocol for canine LSA is ___% with a CR rate of ___%. The PFS was ____.
- RR: 34%
- CR: 17%
- PFS: 2 months
60
The ORR for mustargen, melphalan, vincristine + prednisone (MOMP) as rescue therapy for canine LSA is ___% with a CR rate of ___%. The PFS was ____.
- RR: 51%
- CR: 12%
- PFS: 2 months
61
The ORR for LOPP as rescue protocol for canine LSA is ___% with a CR rate of ___%. The median response duration was _____.
- RR: 61%
- CR: 36%
- PFS: 3 months
62
The ORR of vinblastine as a second rescue protocol for canine LSA is ____% with a CR rate of ___%. The median response duration was _____.
- RR: 25%
- CR: 7%
- PFS: 1 month
63
The ORR of Tanovea as a rescue protocol for canine B-cell LSA is ___% with a CR rate of ____%. The PFS was ____, and the median duration of CR was _____. ___% developed pulmonary fibrosis.
- RR: 74%
- CR: 45%
- PFS: 4mo
- PFS CR: 7 months
- 8% pulmonary fibrosis
64
The ORR of LPP was a rescue protocol for canine LSA is ___% with a CR rate of ___%. The PFS was ____.
- RR: 60%
- CR: 30%
- PFS: 1 month
65
The ORR of temozolomide as a rescue protocol for canine LSA is ____% with a CR rate of ___%. The TTP was ____, and the MST was _____. The ORR of temozolomide/DOX combo therapy is ___% w/ a TTP of ____ and MST of ____. TMZ only has a toxicity rate of ____% whereas TMZ/DOX has a toxicity rate of ___%. Were the differences in TTP statistically significant?
- ORR TMZ: 32%
- CR TMZ: 13%
- TTP TMZ: 15 days
- MST TMZ: 1 month
- ORR TMZ/DOX: 60%
- TTP TMZ/DOX: 19 days
- MST TMZ/DOX: 24 days
- Toxicity TMZ: 46%
- Toxicity TMZ/DOX: 63%
Differences were not statistically different
66
***Small cell T-cell intestinal LSA in dogs treated with chlorambucil and prednisone have reported MSTs ranging from ____-_____.
1.5-2 years
67
***Colorectal lymphoma in dogs generally has a _______ phenotype and is associated with an indolent outcome with PFS and MSTs reported to be _____ after initiation of chemotherapy. The reported PFS is ____ and the MST is _____. ______, _______, and ____ were positive prognostic indicators.
- high grade B cell
- > 3 years
- PFI: 3.6 years
- MST: 5 year
- postive prog: hematochezia, substage b, and younger age < 7 yrs
68
***Canine nodal marginal zone LSA, which is designated as indolent LSA, is generally more aggressive with PFI of _____ and OST of _____.
PFI: 5 months
OST: 9 months
69
What peripheral blood counts at presentation are associated with a unfavorable prognosis in dogs with LSA. Which is these has a strong association?
- anemia (strong)
- thrombocytopenia
- neutrophilia
- low neutrophil/lymphocyte ratio
- low lymphocyte/monocyte ratio
70
Of the CLLs in dogs, approximately ____ are T-cell and _____ are B-cell.
T-cell 2/3rds
B-cell 1/3rd
71
What are the 3 different subtypes of CLL in dogs?
1. T-CLL (CD3+, CD8+)
2. B-CLL (CD21+)
3. atypical CLL
72
What is the most common immunophenotype of ALL in dogs? List markers of both types.
- most common: B-ALL (CD21+, CD3-, CD4-, CD8-, +/-CD34+)
- T-ALL: CD3+, CD4-, CD8-, CD21-, CD34+/-
73
What marker distinguishes AML from ALL?
AML: myeloperoxidase +, negative lymphocyte markers
74
***For canine B-CLL, ___% have peripheral lymphadenopathy, ___% have splenomegaly, ____% have hepatomegaly, ___% have visceral lymphadenopathy, ___% have a mediastinal mass, ___% have hyperglobuminemia, and ___% have hypercalcemia.
50% peripheral lymphadenopathy
50% splenomegaly
30% hepatomegaly
23% visceral lymphadenopathy
3% mediastinal mass
80% hyperglobuminemia
13% hypercalcemia
75
In dogs with CLL, ____% have monoclonal gammopathy.
68%
76
***Approximately ___% of circulating lymphocytes in normal dogs are T cell and ____% are B cell.
T cell 80% (CD4+ > CD8+)
B cell 15%
77
In canine CLL, small lymphocytes occur in excessive numbers in the bone marrow (____% of all nucleated cells).
>/= 30%
78
___% of B-CLL and ___% of T-CLL progress to Richter-like acute disease often characterized by ______ and ____ (clinical signs). The MST after progression is reported to be _____ despite CHOP in 1/2 of patients.
10% B-CLL
2% T-CLL
Lymphadenopathy, neurologic symptoms
MST 1 month
79
For dogs that are treated for CLL, normalization of lymphocyte count is expected in ___% of cases.
70%
80
***The MSTs reported for T-CLL, B-CLL, and atypical CLL are ____, ____, and ____, respectively.
MST T-CLL: 31 months
MST B-CLL: 16 months
MST atypical CLL: <1mo
81
In 1 report of dogs with CD34+ ALL, MST was ____ despite majority receiving CHOP.
16 days
82
Dogs with B-ALL are reported to have MST of ______ independent of treatment protocol
4 months
83
In a 2008 study of 17 dogs with multicentric lymphoma and bone marrow involvement, cytarabine in addition to a CHOP-based chemotherapy protocol was evaluated. What was the MST in the group of dogs that received cytarabine in addition to CHOP? MST without cytarabine? What was the RR in dogs that received cytarabine as part of their chemo?
MST w/ cytarabine: 8 months
MST w/ out cytarabine: 2 months
- RR: 88%
84
A prospective study was designed to evaluate the sensitivity and specificity of abdominal ultrasound for detection of stage IV lymphoma. This study examined 28 dogs with a diagnosis of lymphoma with or without splenic and hepatic involvement. Aspirates were obtained from the liver and spleen in all cases. What was the reported sensitivity and specificity of liver and splenic sonographic appearance for the detection of lymphoma? What is the sensitivity and specificity reported in an older paper from 2010?
Liver
- Sensitivity: 73%
- Specificity: 81%
Spleen
- Sensitivity: 100%
- Specificity: 23%
Older paper 2010:
- Liver: Se 73%, Sp 81%
- Spleen: Se 100%, Sp 23%
85
Serum albumin concentration has been reported to have a positive correlation with survival time in dogs with primary hepatic lymphoma based on a retrospective study on 18 dogs. What is the cutoff of serum ALB concentration in this study that was found to be associated with a significantly shorter MST?
<2.5 g/dL
86
What is the CR rate of dogs with primary hepatic large cell LSA treated with multi-agent doxorubicin based chemotherapy? What is the PFS, oMST, MST for dogs who achieve CR vs. those who do not?
- CR: 44%
- PFS: 4mo
- oMST 2 months
- MST CR: 8mo
- MST no CR: <1mo
87
Rabacfosadine has been evaluated as a treatment for dogs with cutaneous T-cell lymphoma. What was the ORR and biologic response rate? What was the median progression free interval for chemotherapy-naive or relapsed dogs
ORR 45%
Biologic response rate 64%
PFS 1 month
88
FIV infection alone in cats was associated with a ____-fold increase in development of lymphoma.
5
89
For low grade alimentary lymphoma in cats, ___-cell (T or B?) variants are most likely to occur in the small intestine (___%), and rarely in the stomach or large intestine. The majority of these variants are ______ (mucosal or transmural?).
T cell
94%
mucosal
90
The majority of B-cell tumors in cats with low grade alimentary lymphoma are ______ (mucosal or transmural?), which is equivalent to WHO EATCL type ____ classification.
transmural
type I
91
In 1 report of 29 cases of low grade alimentary lymphoma in cats, liver and mesenteric lymph node involvement was documented in __% and ___% of cases, respectively.
liver: 53%
mesenteric lymph node: 33%
92
What immunophenotype is most common with intermediate/high grade lymphoma. What classification type?
B-cell
type 1 (transmural)
93
***Feline low grade alimentary lymphoma treated with chlorambucil and prednisolone has a response rate of >___% and MST of ___-_____.
>80%
1.5-3 years
94
***Feline low grade alimentary lymphoma treated with rescue chemotherapy has a reported MST of ____-_____.
9-29 months
95
Remission rates of __-___% are reported in cats with intermediate to high grade alimentary lymphoma with ___% achieving CR. For those who achieve CR, MSTs range from _____-____ with a subset living 1 year or longer.
50-65%
30%
7-10 months
96
Large granular lymphoma in cats has a response rate of ___% with CHOP and CCNU therapies and MSTs ranging from ____-_____. A small subset (___%) have more durable responses of _______.
30%
2-3 months
7%
>6 months
97
In a study of 23 cats with discrete intermediate to high grade alimentary lymphoma who underwent chemotherapy without surgery, ___% experienced perforation which occurred ___-____ after initiation of chemotherapy. It was concluded this was likely secondary to ________.
17%
2 days to 3 months
progressive disease rather than chemotherapy-induced perforation
98
The MST reported in cats with peripheral non-Hodgkin's LSA is ____-____ whereas the MST with Hodgkin's like LSA is ____.
non-Hodgkin: 6-9 months
Hodgkin: 1 year
99
FeLV negative cats with mediastinal LSA have a response rate of ___% with CHOP/COP and MST of _____. Cats who achieve CR have a MST of ____. FeLV positive cats have a MST of ___-_____.
95%
FeLV negative MST: 12 months
FeLV- CR MST: 33mo
FeLV positive MST: 2-3 months
100
PARR in cats is approximately ___% sensitive for the diagnosis of lymphoma. Specificity has not been clearly established.
80%
101
___% of nasal lymphoma in cats has local extension or distant metastasis at necropsy.
20%
102
In 1 report of 38 cats with nasal lymphoma that was not treated, the MST was ______.
2 months
103
CR rates of ___-___% are reported in cats with nasal lymphoma treated with RT with MST of ____-_____. For cats that do not achieve CR with RT, their MST is ______.
75-95%
MST CR: 1.5-3 years
MST no CR: 5 months
104
A total dose greater than ____Gy is recommended for treatment of feline nasal lymphoma.
32 Gy
105
CR rates of ___% are reported in cats with nasal lymphoma treated with chemotherapy (CHOP or COP) with MST of _____.
75%
2 years
106
Renal lymphoma in cats is bilateral in >___% of cases.
80%
107
___% of cats will experience clinical benefit when treated with chemotherapy (COP/CHOP) for renal LSA with MSTs ranging from ______-______.
67%
4-7 months
108
Generally fewer than __% of cats with CNS lymphoma will respond to chemotherapy with MSTs ranging from ____-_____.
<50%
1-4 months
109
Popliteal lymph node involvement is seen in ___% of cats with tarsal lymphoma.
20%
110
___% of cats with subcutaneous lymphoma will die of their disease, indicating a _________ (aggressive or indolent?) biologic behavior.
75%
aggressive
111
In the largest report of cats with subcutaneous LSA, the PFS was _____ and oMST was ____ following surgical removal.
PFS: 3 months
MST: 5 months
112
A small number of cases of cats with subcutaneous lymphoma treated with a variety of chemotherapy, MST was reported to be _____.
6 months
113
In 7 cases of tarsal subcutaneous lymphoma in cats who received RT and chemotherapy, MST was ______.
7 months
114
____% of cats with laryngeal/pharyngeal/tracheal LSA have regional lymph node involvement.
25%
115
The CR rate in cats with laryngeal or tracheal LSA treated with chemotherapy (COP/CHOP) is ____% with MSTs after CR ranging from _____-_____ according to Withrow.
90%
6-9 months
116
Cats with primary ocular lymphoma treated with enucleation have reported survival times ranging from ______-______.
6 months to 4 years
117
A bone marrow aspirate with greater than ___% abnormal blasts is sufficient to make a diagnosis of acute leukemia in cats. In cats with CLL, infiltration of bone marrow with >____% mature lymphocytes helps support diagnosis.
>30% acute leukemia
>15% CLL
118
Approximately ___-___% of cats with ALL are FeLV+. Most malignant cells have a __-cell immunophenotype
60-80%
T cell
119
In one report of 18 cases of CLL in cats, most were found to be ____ cells. What is the marker positivity?
T-helper (CD3+CD4+CD8-)
120
Using COP-based protocols, ___% CR rate has been reported in cats with ALL.
27%
121
In 16 cats treated with chlorambucil and prednisolone for CLL, ____% responded with median duration of ____. ___% achieved a CR with median duration of _____.
90%
6 months
CR: 50%
CR median duration: 14 months
122
What is the reported response rate for DMAC rescue therapy in cats with lymphoma? What is the PFS and MST from starting DMAC?
26%
PFS 14 days
MST 17 days
123
What is the reported response rate to CCNU when used as a frontline therapy for feline intermediate to large cell GI lymphoma? Median duration of response? What is the PFI and MST?
50%
median duration of response: 10 months
PFI: 4 months
MST: 4 months
124
List the subtypes and descriptions of acute leukemias according to FAB system (Hint: there's 10) and name which one has not been recognized in animals.
- AUL: Acute undifferentiated leukemia
- M1: Myeloblastic leukemia without differentiation
-M2: Myeloblastic leukemia with some neutrophilic differentiation
- M3: Promyelocytic leukemia (not recognized in animals)
- M4: Myelomonocytic leukemia
- M5a: Monocytic leukemia without differentiation
-M5b: Monocytic leukemia with some monocytic differentiation
- M6: Erythroleukemia
- M6Er: Variant of M6 with erythroblasts comprising erythrocomponent
- M7: Megakaryocytic leukemia
125
The relative frequency of AML subtypes in dogs in decreasing order are ________ (__%), _______(___%), __________, _______, and one of each for ______ and ______.
- monocytic leukemia (M5a, M5b) 42%
- myelomonocytic leukemia (M4) 33%
- myeloblastic leukemia without differentiation (M1)
- megakaryocytic leukemia (M7)
- Myeloblastic leukemia with some differentiation (M2) and erythroleukemia (M6)
126
____ is a useful cytochemical marker for AML if neoplastic cells only express CD34.
ALP
127
Currently, the ACVP Oncology Committee recommends that the following immunophenotyping panel for flow cytometry be done on bone marrow and/or blood smears to characterize animal leukemias: for B lymphocytes, ____; for T lymphocytes, ___; for myeloid cells, ___ and _____; for megakaryo-
blasts, _____; for dendritic cells, _____; and for acute leukemias, _____.
- B-cell: CD79a
- T-cell: CD3
- Myeloid cells: myeloperoxidase (MPO) and CD11b
- Megakaryoblast: CD41
- Dendritic cells: CD1c
- Acute leukemias: CD34
128
***Response rates to multi-agent chemotherapy for dogs with AML are ___-___% but are not durable. MSTs range from ____-____. MSTs for palliative care are ____-____.
50-70%
MST chem0: 0.5-2 months
MST palliation: 1-2 weeks
129
A case-controlled study evaluating the associations of environment, health history, and T-zone lymphoma in Golden Retrievers was performed. ______, _______, and ______ were significantly associated with T zone lymphoma.
Hypothyroidism (decreased risk)
Omega-3 fatty acid supplementation (Decreased risk)
Mange (increased risk)
130
***Approximately ___-___% of dogs with multiple myeloma will develop osteolytic lesions.
- dog: 25-67%
131
***High serum viscosity occurs in ___-___% of dogs with multiple myeloma.
20-40%
132
***Renal disease is present in approximately ___-___% of dogs with MM, and azotemia is observed in ____-___% of cats
25-50% dogs
30-40% cats
133
***Bence Jones proteinuria occurs in approximately ___-___% of dogs with MM and ___% in cats.
dogs 25-40%
cats 40%
134
***Hypercalcemia is reported in ___-___% of dogs with MM and ___-___% in cats.
dogs 15-50%
cats 10-25%
135
***For definitive diagnosis of multiple myeloma in dogs, current recommendations require ___% plasmacytosis of the bone marrow. A >___% cutoff in cats with special attention to cellular atypia is also recommended. Normal BM should have <___% of plasma cells.
>20% dogs
> 10% cats
normal <5%
136
***In one case series in cats with MM, ___% of organs with ultrasonographic abnormalities were subsequently confirmed to have plasma cell infiltration.
85%
137
Reduction in serum total globulin for dogs with MM is expected ____-____ following start of therapy.
3-6 weeks
138
A good response to therapy for patients with multiple myeloma is a reduction >____% of pretreatment values in the measured M component.
50%
139
***In a group of 60 dogs with MM treated with melphalan and prednisone, ORR was ___%, CR rate was ___%, and ___% did not respond. The MST was ______.
- ORR: 92%
- CR 43%
- 8% no response
- MST 18 months
140
***In a recent group of 38 dogs treated with melphalan/prednisone for MM, ___% had objective responses (___% for pulse-dose protocol and ___% for continuous daily protocol) with PFS of _____ and MST of ________. Th 3-year survival rate was ____%.
ORR 86%
94% pulse dose
79% continuous dose
PFS: 20 months
MST: 31 months
3-year: 30%
141
List negative prognostic factors for dogs with MM.
Hypercalcemia
Bence-Jones proteinuria
Extensive bony lysis
Renal disease
High neutrophil:lymphocyte ratio
142
____-____% of cats with MM will respond to therapy. Variable MSTs are reported with a recent compilation reporting ___-____.
50-83%
MST 8-13 months
143
9 cats were grouped in an "aggressive" and "non-aggressive" category based on clinical features of MM in one small study. The MST of cats with aggressive MM was _____ and ______ for non-aggressive MM.
MST aggressive: 5 days
MST non-aggressive: 13 months
144
In 9 dogs with IgM macroglobulinemia treated with chlorambucil, ____% achieved remission with a MST of _____.
77%
MST 11 months
145
***Cutaneous plasmacytosis in dogs was associated with lymph node or abdominal viscera involvement in approximately ___% of cases.
30%
146
***In dogs with cutaneous plasmacytosis treated with melphalan or lomustine, response rate is ____%, PFS was ____, and MST was ____.
~75%
PFS 5 months
MST 18 months
147
***Solitary cutaneous or mucocutaneous plasmacytoma in dogs treated with conservative surgical excision have a ___% recurrence rate, and nodal or distant metastasis occurring in ___%.
recurrence rate 5%
metastatic rate 2%
148
***In a compilation of 9 dogs with colorectal plasmacytoma, LR after surgery was ____ and MST was reported to be ____ after surgery alone.
LR: 22%
MST: 15 months
149
The outcome of 18 dogs with CNS LSA was recently assessed. The majority of dogs underwent various treatment (chemo, RT, surgery) besides prednisone alone. The MST was _____.
MST 6 months
150
A retrospective study evaluating presentation and outcome in 29 dogs with suspected primary renal LSA was performed. What was the response rate to chemotherapy? What was the overall PFS and MST and the PFS/MST of dogs that responded to chemotherapy?
RR 48% (all PR)
oPFS: 10 days
oMST: 12 days
PFS responders: 1 month
MST responders: 2 months
151
The majority of peripheral, non-TZL, T cell LSA are CD4+ or CD8+?
CD4+
152
A recent study evaluating the outcome of dogs with peripheral CD8+ or CD4-CD8- T-cell lymphoma was performed. What was the MST of each group? What was the MST based off of large or small cell size determined by flow cytometry?
oMST CD8+: 7 months
oMST CD4-CD8-: 5 months
MST large size: 2 months
MST small size: 9 months
153
A prospective evaluation of flow cytometric characteristics, histopathologic diagnosis, and clinical outcome in dogs with naive B-cell LSA treated with a 19-week CHOP protocol was performed. Dogs with diffuse large B-cell lymphoma (DLBCL) had an ORR of ___% compared to non-DLBCL subtypes (eg, nodal marginal zone, small B-cell, Burkitt-like, follicular) at ___%. What were the PFS of each groups (DLBCL VS. non-DLBCL)?
DLBCL RR: 96%
Non-DLBCL RR: 70%
DLBCL PFS: 8 months
Non-DLBCL PFS: 5 months
154
A genetic and environmental risk factor study in boxers with LSA was performed. What risk factors were associated with increased risk for lymphoma in this study popultation?
proximity to nuclear power plants, chemical suppliers, and crematoria
155
A recent blinded retrospective study assessed ultrasound sensitivity and specificity for lymphoma in both dogs and cats. What were the sensitivity and specificity for liver and spleen? What finding was associated with a B-cell immunophenotype in dogs?
Liver
- sensitivity: ~17%
- specificity: 91%
Spleen
- sensitivity: 73%
- specificity: 94%
leopard-spotted splenic parenchyma
156
A study was performed to evaluate the impact of various neutrophil cutoffs on chemotherapy administration in dogs with LSA treated with CHOP. They found that a neutrophil cutoff of _____ minimized the number of dose delays and was not associated with increased toxicity. They also found that all dogs with neutrophil count between ____ and ____ recovered without prophylactic antibiotics.
1.5 x 10^3/uL
0.75 - 1.5 x 10^3/uL
157
Risk factors associated with the onset of lomustine-induced neutropenia in tumor-bearing dogs were assessed in a study out of Europe. A starting dose > _____ was associated with an increased risk of developing neutropenia. A mortality rate of ___% was found in this study population.
>70mg/m2
1.7%
158
A comparison of 12- and 19-week CHOP protocols was performed. What was CR rate, PFS, and MST between groups? Was this statistically significant?
CHOP-19:
- CR: 90%
- PFS: 8 months
- MST: 12 months
CHOP-12:
- CR: 89%
- PFS: 5 months
- MST: 8 months
Difference in PFS and MST were statistically significant
159
A recent retrospective study evaluating the effects of substituting mitoxantrone for doxorubicin in a multi-agent protocol as front-line therapy for dogs with multicentric intermediate to large cell LSA was performed. What were the response rates, PFS, and MST for CMOP and CHOP groups? Were these findings statistically significant?
CMOP
- RR: 100%
- PFS: 6 months
- MST: 8 months
CHOP
- RR: 97%
- PFS: 7 months
- MST: 12 months
PFS and MST were not statistically significant between groups
160
Cyclophosphamide and prednisolone as initial therapy in naive B-cell LSA dogs was assessed. What was the ORR, CR, PR, and SD rates?
ORR: 84%
CR: 9%
PR: 62%
SD: 12%
161
A study evaluating the response rate and toxicity of a single dose of vinblastine to dogs with naive multicentric intermediate to large cell was performed. What were the response rates at 2 and 2.5mg/m2? ___% of dogs developed neutropenia 1 week post vinblastine given at 2.5mg/m2.
Vinb 2 mg/m2: PR 7%
Vinb 2.5 mg/m2: PR 60%
80%
162
A phase II study of 58 dogs with naive or progressive B- or T-cell LSA evaluating KPT-335 (verdinexor/Laverdia) was performed. What was the overall ORR? ORR for T-cell LSA? What was the most common adverse event?
ORR 37%
ORR T-cell: 71%
Anorexia
163
What is the dose and schedule of Laverdia (verdinexor/KPT-335)?
1.5 mg/kg PO 3 times weekly
164
A phase I study of 18 dogs with peripheral nodal lymphoma treated with survivin inhibitor, EZN-3042, was performed. What was the established dose/schedule that reduced majority of survivin expression? Any DLTs?
8.25mg/kg IV twice weekly
No DLTs were observed
165
Concurrent use of Tanovea and Elspar for relapsed or refractory multicentric lymphoma in dogs was prospectively evaluated. What was the ORR, CR rate, oPFS, and PFS for CR dogs?
ORR: 67%
CR: 41%
oPFS: 2 months
PFS CR: 5 months
166
A retrospective study evaluated the efficacy and tolerability of combination therapy with DTIC and mitoxantrone in dogs with relapsed lymphoma. ___% experienced grade 4 neutropenia. The overall RR was ____ for a median of _____. For dogs that received this as first rescue, the RR was ____%.
18% grade IV neutropenia
oRR: 34%
Median duration of response: 3 months
RR first rescue: 93%
167
What is the ORR to MVPP in dogs with relapsed multicentric lymphoma? PFS? MST?
ORR: 25%
PFS: 15 days
MST: 2 months
168
A study in 2018 evaluated LOPP as first-line therapy in 35 dogs with multicentric T-cell LSA. What was oPFS and oMST? ___% achieved CR with a PFS of ____. What was the toxicity rate?
- oPFS: 14 months
- oMST: 17 months
- CR: 83%
- PFS CR: 17 months
- Toxicity rate: 86%
169
A retrospective study evaluating combination Elspar + CHOP vs. modified MOPP in dogs with multicentric T-cell lymphoma was performed. What was the PFS in each group? What breed had longer PFS in CHOP vs. MOPP?
- PFS L-CHOP: 4 months
- PFS MOPP: 3 months
- Golden retrievers
170
A retrospective study of 31 dogs with multicentric T-cell LSA treated with LOPP as first-line was performed in 2017. What was the ORR, DFI, and MST?
- ORR 97%
- DFI: 6 months
- MST: 11 months
171
What is MST for dogs with previously untreated multicentric intermediate to large cell lymphoma treated with prednisone alone?
50 days
172
What is the ORR of procarbazine, cyclophosphamide, and prednisone (PPC) therapy in dogs with relapsed lymphoma or those that do not tolerate MTD chemo?
- ORR: 70%
- PR: 24%
- CR: 46%
173
What is the cure rate of autologous peripheral blood hematopoietic stem cell transplantation (HCT) in dogs with high grade B-cell lymphoma?
33-40%
174
What is the DFI and MST in dogs with high grade B cell lymphoma treated with allogeneic peripheral blood hematopoietic stem cell transplantation (HCT)? A cure rate of ___% was found, meaning that allogeneic HCT can cure ~___% more dogs than autologous HCT.
- oDFI: 37 months
- oMST: 37 months
- 89%
- 50%
175
A recent retrospective study compared outcome in cats with sinonasal lymphoma treated with hypofractionated RT (HRT) + CHOP/COP-based chemotherapy vs. HRT alone. What were the PFS and MST of each group?
HRT + chemo:
- PFS: 23 months
- MST: 33 months
HRT alone:
- PFS: 4 months
- MST: 9 months
176
A recent retrospective study evaluating 23 cats with laryngeal or tracheal lymphoma treated with chemotherapy +/- surgical debulking (26%) was performed. What was the PR and CR rates? What was the PFS and MST? Immunophenotyping was performed in 48% of cases and all were __-cell.
- PR: 35%
- CR: 65%
- PFS: 30 months
- MST: 30 months
- B-cell
177
A retrospective study evaluating outcome of 32 cats treated with SBRT for nasal lymphoma was performed. What was the PFS, MST, acute toxicity rate, and chronic rhinitis rate? What factors were associated with shorter outcome?
- PFS: 8 months
- MST: 12 months
- Acute toxicity: 0%
- 75% chronic rhinitis
- cribiform lysis and intracranial involvement
178
A retrospective study evaluating incidence and treatment of renal lymphoma in 27 cats was performed. Cats treated with prednisolone alone had a MST of ____ compared to cats treated with L-CHOP at ______.
- MST pred: 50 days
- MST L-CHOP: 7 months
179
Lomustine, methotrexate, and cytarabine for rescue chemotherapy for large cell lymphoma in 13 cats was assessed. In cats that received all 3 drugs, ___% demonstrated a complete or partial response to therapy. What was the PFS?
46%
PFS 2 months
180
A prospective study of 12 cats with intermediate to large cell GI LSA treated with lomustine and 8 Gy abdominal cavity radiation therapy was performed. ___% developed cytopenias, resulting in treatment delays. The overall RR was ___% (all PR). What was PFS and MST?
- 44% cytopenia
- ORR 50%
- PFS: 3 months
- MST: 3 months
181
Outcomes of 40 cats with discrete intermediate to large cell GI lymphoma treated with surgery was assessed. Cats that survived to suture removal had a MST of _____. Cats with a large intestinal mass and complete resection had improved MST (LI MST: ____; complete resection ____).
- oMST 6 months
- MST LI: 23 months
- MST Complete resection: 12 months
182
What is the reported response rate of MOPP as rescue therapy for cats with lymphoma? Among responders, the median response duration was _____. The most common adverse effects were neutropenia and GI upset, which were reported in ___% of cases.
- ORR: 70%
- Median response duration: 6 months
- 18%
183
Large cell LSA has been reported to occur in ___% of cats treated for small-cell GI LSA.
10%
184
____% of cats achieve a CR with cyclophosphamide rescue therapy for small-cell GI LSA for a median duration of _____.
90%
8 months
185
A retrospective evaluation of the use of the International Myeloma Working Group response criteria in dogs
with secretory multiple myeloma was performed. MST was longer for dogs that attained ≥90% densitometric M-protein reduction (____) than for those that did not attain at least 50% reduction in densitometric M-protein (_____). What response diagnostics did not correlate with outcome?
- MST >90%: 21 months
- MST: <50%: 10 months
- Serum globulins and radial immunodiffusion (RID)
186
Cyclical 10-day dosing of melphalan for canine multiple myeloma was reported. Based on serum globulin concentrations, ___% achieved CR, and ___% achieved PR, for an overall response rate of ___%. The MST was ____. Adverse events were minimal with ______ being the most reported.
CR: 59%
PR: 18%
ORR: 76%
MST: 17 months
diarrhea
187
Response and outcome following radiation therapy of macroscopic canine plasma cell tumors was evaluated. ___% achieved CR, ___% achieved PR for an ORR of ___%. The PFS was _____. MST for non-MM cases was _____ and for all cases was _____.
CR: 73%
PR: 23%
ORR: 95%
PFS: 20 months
MST non-MM: 26 months
oMST: 23 months
188
A recent retrospective evaluation of the outcome of solitary osseous plasmacytoma in 13 dogs was performed. What was the most common site? What was the overall PFS and MST? What was MST following completion of radiation therapy? ___% progressed to multiple myeloma.
- vertebrae
- PFS: 10 months
- oMST: 30 months
- MST RT: 39 months
- 0%
189
A retrospective study of canine oral extramedullary plasmacytoma over a 15-year period was performed. The MST after various treatment (surgery, RT, and/or chemotherapy) was ______. ___% of dogs had progression of plasma cell disease with ___% being myeloma-like. Cases without tumor progression did not exceed ___ mitotic figures in ten HPFs.
- MST: 32 months
- ~ 30%
- 4%
- 28 MC
190
Alterations and deficiencies in DNA repair mechanisms have been found in what dog breed with lymphoma.
Goldens
191
***What are the 4 most common anatomic forms of lymphoma in the dog in order of decreasing prevalence?
Multicentric > GI > mediastinal > cutaneous
192
***Epitheliotropic cutaneous LSA in dogs is of what specific immunophenotype, unlike humans?
- typically CD8+ T cells
- humans: CD4+ T cells
193
Intravascular LSA in dogs has been reported to be what immunophenotypes?
- T cell or null cell
194
***______ is a heterogenous accumulation of lymphocytes (both B and T cells), neutrophils, plasma cells, and macrophages often arranged angiocentrally.
Pulmonary lymphomatoid granulomatosis
195
***In a compilation of 100 cases of ocular lymphoma in dogs, _____ were presumed solitary ocular LSA (PSOL) with no progression post-enucleation. MST of dogs with PSOL were _____ vs. _____ for dogs with systemic involvement.
- 61% PSOL
MST:
- PSOL: 26mo
- systemic LSA: 3mo
196
***A study compared PARR and Flow cytometry to the gold standard, IHC, for immunophenotyping dogs with LSA. The agreement in diagnosis between FC and IHC was ___%, ____% for PARR and IHC, ____% for FC and PARR, and ___% for all three. The sensitivity of diagnosing B-cell LSA via flow cytometry was ____% and T-cell LSA was ___% for an overall sensitivity of ____%. The specificity of FC for diagnosing B-cell LSA was ___% and ___% for T-cell LSA. The sensitivity for diagnosing B-cell LSA with PARR is ___% and _____% for T-cell LSA for an overall sensitivity of ___%. The specificity of PARR for diagnosing B-cell LSA is ___% and the sensitivity is ____%.
Agreement:
- 94% FC and IHC
- 69% PARR and IHC
- 63% PARR and FC
- 63% all three
FC:
- Se B-cell: 91%
- Se T cell: 100%
- Overall Se: 98%
- Sp B-cell: 100%
- Sp T cell: 98%
PARR:
- Se B-cell: 67%
- Se T-cell: 75%
- Overall Se: 74%
- Sp B-cell: 100%
- Sp T cell: 98%
197
***A randomized trial comparing DOX/prednisone and DOX/Cytoxan/pred for naive canine LSA reported a numerically but not statistically improved outcome with multi-drug therapy (PFS _____ vs. ______).
PFS:
- Dox/pred: 6mo
- Dox/cytoxan/pred: 8mo
198
Dogs with cutaneous epitheliotropic or nonepitheliotropic LSA have RR of ____-___% to chemotherapy with median remission durations of ____-____.
- RR: 40-80%
- median remission durations: 3-6mo
199
***Prognostic factors most consistently identified for peripheral LSA in dogs is the _______, _______, and _______.
- immunophenotype
- WHO substage
- indolent sub-classification
200
***B-cell LSA in dogs that express lower than normal levels of ______ or low levels of ____ have a shorter remission and survival.
- lower levels of B5 antigen and MHCII
201
The treatment of dogs with naive LSA with VMC-L (vincristine, methotrexate, Cytoxan, and Elspar) has reported RR of ___-___%, PFS of ____, and a 1-year survival of ___%.
- RR: 80-90%
- PFS: 4mo
- 1 year: 25%
202
The treatment of dogs with naive LSA with UW-25 results in RR of ___%, PFS of ____, and MST of ____. 15-week CHOP results in RR of ___-___%, TTP of ___-____, and STs of ___-____. 12-week CHOP results in RR of ___%, PFS of ____, and 1 year remission of ___%.
UW-25 (Elspar included)
- RR: 94%
- PFS: 9mo
- MST: 13mo
15-week CHOP
- RR: 98-100%
- TTP: 5-6mo
- ST: 9-10mo
12-week CHOP (Elspar included):
- RR: 89%
- PFS: 8mo
- 1 year remission: 28%
203
The treatment of dogs with naive LSA with COArP (Cytoxan, vincristine, Cytosar, prednisone) resulted in a RR of ___%, PFS of ____, and MST of ____.
- RR: 92%
- PFS: 3mo
- MST: 10mo
204
An older paper evaluating alternating Tanovea/DOX for dogs with naive LSA reported a RR of ___%, CR rate of ___%, and TTP of _____.
- RR: 84%
- CR: 68%
- TTP: 7mo
205
What percentage of dogs with large B-cell LSA will have normal CBCs but exhibit bone marrow involvement when assessed via flow cytometry?
15%
206
***Intermediate to high grade alimentary LSA in cats occurs most commonly in what locations?
stomach, distal SI, cecum, and colon
207
***A study of 26 cats with abdominal large cell lymphoma treated with intraperitoneal-delivered COP reported a CR of ___% with MST of _____. Median duration of first remission was ____ with a 1-year disease free period of ___% and 2-year of ___%. 2-year survival rates was ___%. Adverse events were generally mild with most common event being ______. The highest grade AE was grade 3 _____.
- CR: 75% MST 1yr (13mo)
- DFR: 14mo
- 1 year disease free: 67%
- 2 year disease free: 48%
- 2 year survival: 46%
- most common AE: Obstipation
- grade 3 hair loss
208
The majority of cats with cutaneous LSA have an immunophentype of ____ and _____ for subcutaneous lymphoma.
- cutaneous: T cell (epitheliotropic and non-epitheliotropic)
- subcutaneous: B cell
209
The PFS and OST for dogs and cats with intraocular LSA is _____. ____% of dogs develop neurologic signs. For conjunctival LSA in dogs and cats, the PFS is _____ and the MST is _____.
Intraocular:
- PFS and OST: 6mo
- 100% dogs develop neurologic signs
Conjunctival:
- PFS: 7mo
- MST: 18mo
210
***What is the median remission duration of cats with high grade abdominal lymphoma treated with 6-week combination chemotherapy followed by whole-abdomen fractionated RT (10 x 1.5Gy)?
not reached : >9->44mo
211
***Cats with stage 1 nasal lymphoma treated with MV RT to median dose of 42Gy and 6 months of multi-agent chemotherapy have a CR rate of ___%, local recurrence rate of ___%, ____% distant relapse, PFI of ____, MST of ____, and ______ has a negative impact on survival.
- CR: 90%
- LR: ~25%
- Distant relapse: ~15%
- PFI: 31mo
- MST: 31mo
- cribiform lysis
212
***Cats with nasal lymphoma treated with RT, chemotherapy, or a combination of the two have a DSS of ______ regardless of treatment modality. Anemia has a negative impact on survival with MST of _____. Complete response to treatment and RT dose >32 Gy have positive impacts on survival with MST of ____ and _____, respectively. No significant differences were found between treatment groups but a higher dose of RT may control local disease and improve survival. The overall ORR is ___% with combination therapy having a ORR of ___%, RT ORR ___%, and chemo ORR ___%. The overall duration of response for combination therapy was ____, _____ for RT, and _____ for chemotherapy. The DSS for combination therapy is ____, for RT is _____, and for chemo is _____.
- oDSS: 18mo
- MST anemia: 3mo
- MST CR: 18mo
- MST >32Gy: 12mo
ORR: 70%
- combo: ~80%
- RT: ~95%
- Chemo: ~65%
Duration of response:
- combo: 4mo
- RT: 9mo
- chemo: 2mo
DSS:
- combo: 16mo
- RT: 48mo
- chemo: 11mo
213
Does exclusion of prednisone from L-CHOP affect PFI and MST? What are the PFI and MST of L-CHOP and L-CHO? What were the CR and PR rates of each?
- No
PFI:
- L-CHO: 5mo
- L-CHOP: 10mo
MST:
- L-CHO: 9mo
- L-CHOP: 12mo
CR/PR:
- L-CHO: CR 70%, PR: 30%
- L-CHOP: CR: 70%, PR: 30%
214
***What is the ORR, CR rate, PFS, and LSS of COP in feline high grade lymphoma with vinblastine or vincristine? ____% of cats developed GI toxicity to vincristine compared to ___% for vinblastine. What were two negative prognostic factors in this study?
ORR COP:
- w/ vinblastine: 50%, CR: 18%
- w/ vincristine: 56%, CR: 11%
PFS COP:
- w/ vinblastine: 2mo
- w/ vincristine: 2mo
LSS COP:
- w/ vinblastine: 5mo
- w/ vincristine: 5mo
GI toxicity:
- vinb: 10%
- vinc: 44%
Negative prognostic factors:
- baseline weight <4.2kg
- anemia
215
What is the PFS and MST of cats with high grade LSA treated with UW-25 (L-CHOP) with vinblastine and vincristine? Was choice of vinca significant? What were the prognostic factors?
PFS UW-25
- w/ vinblastine: 3mo
- w/ vincristine: 2mo
MST UW-25:
- w/ vinblastine: 5mo
- w/ vincristine: 3mo
- choice of vinca not significant
Prognostic factors:
- Response to treatment: CR improved PFS/MST
- Anatomic form: Renal decreased PFS/MST
- Subtype: LGL decreased PFS
216
______ is a preleukemic syndrome characterized by peripheral pancytopenia and bone marrow hyperplasia with maturation arrest. In cats, usually associated with ____.
Myelodysplasia
FeLV
217
Similar to humans, mutations in ____, ____ and ____ sequences have been identified in dogs with AML. ______ translocation is also reported in dogs with AML.
flt-3, c-kit, ras
BCR-ABL translocation
218
What are cytochemical markers for neutrophils, monocytes, megakaryocyte, and basophils?
- neutrophil: peroxidase, Sudan black B, chloracetate esterase
- monocyte: alpha-naphthyl acetate esterase, alpha-naphthyl butyrate esterase
- megakaryocyte: acetylcholinesterase, vWF, platelet glycoproteins
- basophil: omega exonuclease, choracetate esterase
219
***Granulocytes in dogs, but not humans, can express what T-cell marker?
CD4
220
***In one report, ____% of dogs with AML had clonal or biclonal rearrangement of either T- or B-cell.
64%
221
***____ mutations have been reported in 1 out of 5 dogs (20%) with primary polycythemia vera. This mutation is seen in ___% of humans.
JAK2
90%
222
***There is speculation that ______, which is a JAK2 inhibitor can be used for treatment of PV in some dogs.
Apoquel (oclacitinib)
223
***_____ and ____ cells lines may be affected with CML so you may seen what on bloodwork (in addition to neutrophilia?
- erythroid and megakaryocytic cell lines
- anemia, thrombocytopenia, rarely thrombocytosis
224
***Death in dogs with CML is usually from ____ or _____ secondary to ______ or _____, respectively.
- infection or hemorrhage
- neutrophil dysfunction or thrombocytopenia
225
_____ is the most effective agent for treating CML during chronic phase and is continued until leukocyte count falls to ____-____ before reducing the dose by 50% for daily maintenance therapy. What other agents can you consider?
- hydroxyurea
- 15-20k
- imatinib, Palladia, vincristine, prednisone
226
What TKI induced clinical remission and partial cytogenetic response in a dogs treated with CML?
Palladia
227
The majority of dogs with CML survive for ____.
1+ year
228
***_____ is a consistent feature on bone marrow evaluation in dogs with essential thrombocythemia and ______ may be evident. What is NOT evident?
- megakaryocytic hyerplasia
- dysplastic changes in megakaryocytes
- no evidence of myelofibrosis or circulating blasts
229
***What may be the underlying pathogenesis of myelofibrosis?
breakdown of intramedullary megakaryocytes and subsequent release of factors that promote fibroblast proliferation or inhibit collagen breakdown
230
***What are consistent clinical features seen with myelofibrosis?
anemia, thrombocytopenia, splenomegaly, myeloid metaplasia
231
What are potential causes of secondary myelofibrosis?
- drug toxicity (estrogens, cephalosporins)
- Ehrlichiosis
- Septicemia
- FeLV
- Other neoplasms
232
What are changes seen on bone marrow evaluation with myelodysplastic syndrome?
- normo- or hypercellular w/ dysplastic changes seen in several cell lines
- if blasts are present, they make up <20% of all nucleated cells
233
What are poor prognostic factors of myelodysplastic syndrome?
% of blasts, cytopenia > 1 lineage, cellular atypia
234
In addition to growth factors, what are 5 factors that induce differentiation of hematopoietic cells that you can consider giving for myelodysplastic syndrome if needed?
- retinoic acid analogs
- vitamin D
- INF-alpha
- 6-thioguanine
- Cytosar
235
____ cell morphology is seen in 25% of cats with multiple myeloma.
flame cell morphology
236
The majority of cats (78%) with multicentric non-cutaneous MRD/EMP have _________ morphologies in contrast to multiple myeloma.
- well-differentiated (MM = mostly anaplastic)
237
Clinical evidence of hemorrhage is seen in ___-___% of dogs and ____% of cats with multiple myeloma.
- dog: 10-30%
- cat: 25%
238
In a retrospective study of 83 dogs with retinal hemorrhage, ___% were due to multiple myeloma.
5%
239
What are the most common CBC abnormalities in dogs and cats with multiple myeloma in descending order?
Dog:
- leukopenia (80%)
- normocytic normochromic non-regenerative anemia (50-67%)
- thrombocytopenia (30%)
Cat:
- Anemia (67%)
- Thrombocytopenia (50%)
- neutropenia (33%)
240
Reductions in serum Ig levels may lag behind reductions in Bence Jones proteinuria for MM. What are the half lives of serum Ig and Bence Jones?
- Ig: 15-20 days
- BJ: 8-12d
241
***A case report exists of a dog with MM that was resistant to melphalan and DOX and achieved a PR with ____ that was maintained for 6 months.
Palladia
242
List 6 breeds predisposed to plasmacytomas.
1. Cockers
2. GSDs
3. Boxers
4. Airedales
5. Westie
6. Yorkie
243
What location of EMP is more commonly associated with lymph node metastasis?
GI
244
What form of plasmacytic tumors in dogs and cats are more commonly associated with progression into multiple myeloma?
- dog: SOP
- cat: cutaneous
245
***_____ has been used for lingual plasmacytoma in a dog.
Sr-90
246
What are two prognostic factors in EMP biopsy samples?
DNA ploidy
Myc expression
