CHOP for lymphoma (again!)

Re: CHOP for lymphoma (again!)

Claire Fisher — Wed, 17 Oct 2012 17:10:34 GMT

There's a pretty through review in The Veterinary Journal April 2011, 188 (1)

The staging and treatment of multicentric high-grade lymphoma in dogs: A review of recent developments and future prospects

Re: CHOP for lymphoma (again!)

Martin Atkinson — Wed, 17 Oct 2012 15:09:49 GMT

[quote user="Elizabeth Tuley"] it makes sense to continue the pred at least as long as the other chemo agents.[/quote] Exactly - given that preds on their own can so good job of eliciting temporary remission it makes sense to continue especially as they are the least cytotoxic of all the agents. I thought the modification was the inclusion of asparginase as the jury is out on the effectiveness of that.

Re: CHOP for lymphoma (again!)

Elizabeth Tuley — Wed, 17 Oct 2012 14:56:47 GMT

[quote user="Martin Atkinson"]

Interesting Elizabeth, mine is a modified Wisconsin-Madison Protocol but the preds continued at alternate day dosage for the whole course. When I asked the venerable Roger Baker, oncologist from The Cancer Centre in Whitstable, he suggested continuing the preds once the main chemo was finished but no time frame as we didn't really expect it to live for so long. I later discussed it with Gerry Polton who broadly agreed with that but reckoned that after over 2 years it was probably cured rather than in remission and could come off especially as the 'roids had turned it into a lump of lard (not without a bit of help from its lardy owners it has to be said)!

[/quote]

Hmm, that is interesting. I assume the 'modification' aspect of your protocol is the continuation of the pred course then, which was presumably extended from the original 5 weeks. I didn't question it at the time, was more relieved to start tapering the pred dose as the owners were struggling to manage the pu/pd and polyphagic side effects. I'll definitely look into your version in the future though - it makes sense to continue the pred at least as long as the other chemo agents.

Re: CHOP for lymphoma (again!)

Martin Atkinson — Wed, 17 Oct 2012 14:02:13 GMT

[quote user="Elizabeth Tuley"]I have used the Madison-Wisconsin CHOP protocol in dogs, it is 25 weeks long but the pred is only for the first 5 weeks and then tapers off. [/quote] Interesting Elizabeth, mine is a modified Wisconsin-Madison Protocol but the preds continued at alternate day dosage for the whole course. When I asked the venerable Roger Baker, oncologist from The Cancer Centre in Whitstable, he suggested continuing the preds once the main chemo was finished but no time frame as we didn't really expect it to live for so long. I later discussed it with Gerry Polton who broadly agreed with that but reckoned that after over 2 years it was probably cured rather than in remission and could come off especially as the 'roids had turned it into a lump of lard (not without a bit of help from its lardy owners it has to be said)!

Re: CHOP for lymphoma (again!)

Claire Fisher — Wed, 17 Oct 2012 13:58:09 GMT

We have a dog currently being treated at Liverpool and they do a 25 week protocol. If they relapse I believe the first line is to restart the same protocol and then try other rescue drugs if there is no response.

Re: CHOP for lymphoma (again!)

Elizabeth Tuley — Wed, 17 Oct 2012 12:27:20 GMT

I have used the Madison-Wisconsin CHOP protocol in dogs, it is 25 weeks long but the pred is only for the first 5 weeks and then tapers off. The case I am thinking of only finished the course at the end of August but is doing really well so far.

Re: CHOP for lymphoma (again!)

Martin Atkinson — Wed, 17 Oct 2012 11:08:29 GMT

My protocol goes to 27 weeks then I would continue with Prednisolone at the rate you finished at (mine would be 40mg/msq q 48hrs). The last dog I had on CHOP is still alive over 3 years later (admittedly it also had L-Asparaginase as well but we stopped the Dox after 2 sessions because of the GI signs) , I carried on with the preds for 2 years before I stopped.