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Small Animal Medicine II > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

Canine lymphoma

Background

A

> 90% of canine hemolymphatic neoplasia

A round cell tumor!

One of the most common cancers seen in the dog

Signalment:
Boxer, Basset Hounds, St. Bernards, Scottish terriers, Airdales, Bulldogs, Rottweillers, Goldens

Age: 6-7 years

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2
Q

Why is lymphoma common?

A

One of the most active cells!

Has mechanisms that are in place to divide rapidly

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3
Q

Canine Lymphoma

Common locations

A

Enlarged peripheral lymph nodes (80%)
GI (10%)
Leukemia

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4
Q

Canine Lymphoma

Cell type

A

Majority are B cell

Depends on breed

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5
Q

Canine Lymphoma

Diagnosis and Phenotyping

A

B vs. T cell

Cytology: can know B vs. T cell
Flow cytometry
IHC
PARR assay (clonality)

Histopathology
Immunohistochemistry

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6
Q

Canine Lymphoma

Stage I

A

Single node (or organ)

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7
Q

Canine Lymphoma

Stage II

A

Group of nodes on one side of diaphragm (thorax or abdomen)

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8
Q

Canine Lymphoma

Stage III

A

Generalized lymph node involvement

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9
Q

Canine Lymphoma

Stage IV

A

Spleen or liver involvement (into the blood stream; easy for lymphocytes to do)

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10
Q

Canine Lymphoma

Stage V

A

Bone marrow

CNS

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11
Q

Canine Lymphoma
Staging
a vs. b

A

a: no symptoms
b: symptoms/sick (poorer prognosis)

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12
Q

Canine Lymphoma

Diagnostics

A

CBC/Chem/UA
Thoracic radiographs
Abdominal imaging; ultrasound most specific
Bone marrow aspirate

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13
Q

Canine Lymphoma

How important is staging

A

Not the most important, treatment approach is generally the same

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14
Q

Canine Lymphoma

Anatomical Classification

A 
Multicentric
Gastrointestinal
Mediastinal
Cutaneous
Extranodal (heart, kidney)
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15
Q

Canine Lymphoma

Histologic Classification

A

Not always done but more useful than staging

Get:
Low grade (small cell)
Intermediate grade (diffuse large cell)
High grade (immunoblastic; 90%, B cell)
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16
Q

Canine Lymphoma

Treatment Success

A

Extremely sensitive to chemotherapy but usually NOT curable

85-90% will achieve remission with chemo (no longer showing clinical signs, no longer hypercalcemic)

Average survival is 1 year

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17
Q

Canine Lymphoma

Factors associated with poorer prognosis

A 
Substage b
Stage greater than III
T-cell
Hypercalcemia
Icterus
Hypoproteinemia
Long history of being on Pred

Means will most likely not live past 1 year

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18
Q

Canine Lymphoma

Common drugs used

A 
Prednisone
L-aspariginase -Elspar-(antimetabolite)
Vincristine (mitotic spindle interrupter)
Cyclophosphamide (alkylator)
Doxorubicin (antitumor antibiotic) 
Methotrexate (antimetabolite)
Lomustine (alkylator)
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19
Q

Canine Lymphoma
Survival/Duration of first remission
No Therapy

A

1 month

Especially high grade

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20
Q

Canine Lymphoma
Survival/Duration of first remission
Prednisone alone

A

2 months

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21
Q

Canine Lymphoma
Survival/Duration of first remission
COP

A

Cyclophosphamide
Vincristine
Prednisone

4-6 months

22
Q

Canine Lymphoma
Survival/Duration of first remission
Elspar+COP

A

L-aspariginase
Cyclophosphamide
Vincristine
Prednisone

4-6 months

23
Q

Canine Lymphoma
Survival/Duration of first remission
COP + Doxo +/- Elspar

A 
AKA: Madison Wisconsin Protocol 
L-aspariginase 
Doxorubicin
Cyclophosphamide
Vincristine
Prednisone

8-9 months

24
Q

What occurs when a patient is out of remission?

A

May no longer respond to chemo drugs

25
Q

Canine Lymphoma
Survival/Duration of first remission
Doxorubicin

A

4-6 months

26
Q

Canine Lymphoma

What to do at relapse

A

Start your protocol over

Switch to new protocol with new drugs (T cells especially)

27
Q

Canine Lymphoma

Rescue protocols

A

Lomustine +/- Elspar
Doxorubicin and DTIC
Lomustine and Vinblastine

28
Q

Lymphoma

Other treatment besides chemotherapy

A

Surgery: only if it is know to be in a single node - must stage it

Radiation therapy: certain locations (ex. nasal)
Entire body radiation and bone marrow transplantation

29
Q

Feline Lymphoma

Background

A

High incidence of lymphoma in cats
Presentation varies with age, FeLV status, locality

No breed predilection

May be related to second hand smoke; toxin ingested when grooming self

30
Q

Feline Lymphoma

Young cat

A

4-5 years old
FeLV (+)
Mediastinal

31
Q

Feline Lymphoma

Older cat

A

9-10 years
FeLV (-)
GI or abdominal

32
Q

Feline Lymphoma

Anatomic Location

A 
Alimentary/GI
Mediastinal
Multicentric
Nasal
Renal
Nasal
Renal
Spinal 
Leukemia
33
Q

Feline Lymphoma

Classification: Stage

A

Multiple schemes but not as helpful as in the dog

Anatomical classification most useful

Single organ involvement tends to do better

34
Q

Feline Lymphoma

Treatment of high grade

A

Same drugs as in dogs, but cats are more likely to experience side effects

COP +/- Elspar
Madison Wisconsin (especially for GI)
35
Q

Feline Lymphoma

Radiation Therapy

A

Single node or nasal; must be Stage I only

36
Q

Feline Lymphoma
Survival/remission
No Treatment

A

1-2 months

37
Q

Feline Lymphoma
Survival/remission
Chemotherapy

A

3-8 months

Even up to 2 years

38
Q

Feline Lymphoma
Survival/remission
Nasal lymphosarcoma

A

18-24 months

39
Q

Feline Lymphoma
Survival/remission
Stage V

A

Poor prognosis

40
Q

Feline Lymphoma
Survival/remission
FeLV(+)

A

6 months

41
Q

Leukemia

What is it?

A

Proliferation of neoplastic hematopoetic cell in bone marrow then spreads via blood

A round cell tumor!

Relatively rare

No real breed or age predilection

42
Q

Leukemia

Clinical Signs

A 
Weakness/depression/lethargy/anorexia
Fever
Bleeding 
Signs of hypercalcemia
Asymptomatic 
Lymphadenopathy
Splenomegaly 
Neurologic signs
43
Q

Leukemia

Classification

A

Acute (blastic) or chronic

Lymphocytic (treatable) or non-lymphocytic

44
Q

Leukemia

What is aleukemic leukemic

A

Proliferation in the bone marrow without the appearance of the abnormal cells in the peripheral blood

45
Q

Leukemia
Diagnosis-CBC
Acute

A

Presence of blasts
May require cytochemical stains or flow cytometry to determine cell origin

Growing fast

46
Q

Leukemia
Diagnosis-CBC
Chronic

A

Over abundance of one mature cell type (slow progression)

Most commonly lymphocytic

Cells not going through apoptosis

47
Q

Leukemia
Diagnosis-CBC
Aleukemic

A

Anemia
Thrombocytopenia
Pancytopenias

48
Q

Leukemia

Diagnosis-Bone Marrow

A

Assists in diagnosis of cell type (lymphocytic or myelogenous)

Estimating prognosis

May require IHC for definitive diagnosis (tells you what cell type it is)

49
Q

Leukemia

Therapy-Acute Lymphocytic Leukemia

A

Treatable but requires aggressive treatment than solid forms

Anthracycline and Elspar +/- Cytosar

Remission time = shorter than solid forms

50
Q

Leukemias

Therapy-Acute Non-Lymphocytic Leukemia

A

Prognosis extremely poor

Aggressive therapy done ASAP
Cytosine Arabinoside (can also combine with anthracycline)

No white cells, no platelets, no RBCs

51
Q

Leukemia

Therapy - Chronic Lymphocytic Leukemia

A

Chronic disease in dogs, rare in cats

Lymphocytosis (extreme)

Chlorambucil every other day alternating with pred

Survival: 1-3 years

Small Animal Medicine II (17 decks)

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