What is the most common hematopoietic tumor?
Fill in the blanks
(E.g. Lymphoid cells in Bone Marrow -- Lymphoid Leukemia
Lymohoid cells in the Body -- Lymphoma)
T- and B- Lymphocytes -- __________
Macrophages -- ______ leukemia
Neutrophils -- ______ leukemia
PTLs -- __________
RBC -- ______leukemia or __________
Erythroleukemia or Polycythemia vera
In which ways are lymphomas classified in dogs?
Lymphoma type (blastic or cytic)
What is the importance of phenotype and lymphoma type classification?
Prognostication: B-cell = Better, T-cell= Terrible
Cytic= Better than blastic
Lymphoma is based on the number of _____ affected.
How is lypmhoma classified in cats? What is the most common form?
Small cell (low grade) vs Large cell (intermediate-high grade)
Most common: Intermediate grade Large Cell Alimentary/GI
How do most dogs with lymphoma present?
Clinically healthy (substage a)
You know what to do.
1. Retropharyngeal and Submandibular
What type of lymphoma causes dyspnea, muddled eart sounds, pre-caval syndrome, and often paraneoplastic hypercalcemia?
What breed of cat is over-represented in terms of lymphoma cases?
How do most cats with lymphoma present?
Moderately Sick (substage b)
Often with GI signs (since alimentary is most common)
Why is an opthamological exam important to include in your physical exam when trying to diagnose lymphoma in a dog?
Uveitis/Retinal hemorrhage occurs in 30-50% of dogs
What will you generally find in a CBC in a dog with a neoplastic condition?
Normocytic normochronic non-regenerative anemia
Myelopthisis - neutropenia, thrombocytopenia, anemia
What sites do you use for a bone marrow aspirate in dogs? Cats? Why is this done?
Dog: Greater tubercle of humerus, Iliac Crest
Cat: Demoral intertrochanteric fossa
For prognosis and staging
What is the most common imaging modality for lymphoma diagnosis?
What is the gold standard for multicentric lymphoma diagnosis? Why? What will you find?
Histopathology of biopsy + Flow-cytomoetry of FNA
Cytology for immunophenotype, Histopath for grade of tumor
Will see - Cytology: Anisocytosis, Anisokaryosis, Multiple nulcei, Mitotic figures, Free nuclear material
IHC: stain for B and T cell markers
How long will a dog or cat live if lymphoma is not treated?
Is chemotherapy better for cats or dogs with lymphoma?
What is the most common chemo protocol for canine lymphoma?
Multi-agent: CHOP protocol (CDVP protocol)
Why may you not be able to treat a dog with chemotherapy if the dog is highly aggressive?
Because most drugs must be given IV and in hospital
How long can a dog live with lymphoma solely on pred?
What is the most common chemotherapy protocol for cats with lymphoma?
Multi-Agent: Modified Wisconsin-Madison Protocol
Or: COP protocol (cyclophosphamide, vinrcristine, pred)
What drug can you give cats with low-grade small cell alimentary lympoma?
Chlorambucil + Prednisolone
What drugs/drug combinations can you give dogs with low-grade lymphoma?
Chlorambucil + Pred
Cyclophosphamide + Pred
(Surgery if confined to spleen or solitary LN)
How long should intitial lymphoma treatment be given?
Since relapse occurs in most, if not all patients, what protocol can you use if the replapse occurs more than 2 months after the initial treatment course? Less than 2 months?
<2mo: Same as initial protocol
>2mo: Cannot use any drugs from initital therapy due to resistance development, "Rescue chemo" - Lomustine/CCNU, Mitoxantrone, Melphalan
What genetic test should be performed before intitiating chemotherapy in dogs?
MDR-1 gene analysis
What type of lymphoma respons well to radiation?
What does it indicate if a dog develops chemotherapy induced neutropenia?
It's a GOOD thing- indicates prolonged remission rate
What is the proliferation of neoplastic cells in the bone marrow? How is it categorized?
Categorized as acute lymphoblastic (ALL) or chronic lymphocytic (CLL)
(Note: Acute lymphoblAstic , Chronic lymphoCytic)