Feline Sino-Nasal Lymphoma - best treatment options

RE: Feline Sino-Nasal Lymphoma - best treatment options

Martin Atkinson — Tue, 13 Dec 2016 15:14:47 GMT

[quote user="Iain McAllister"]

Thanks - what COP protocol do you recommend as I know there are a few variants...

[/quote]

Low dose COP: Vincristine 40mg/msq IV q 7 days for 2 months; cyclophosphamide per os 50mg/msq given pro-rata so you can give 50mg tablets unbroken to achieve that dose in a week (typical 4kg cat = 0.25msq so one tablet weekly for 2 months); preds 20mg/msq daily for 7 days then eod. After 2 months vincristine and cyclosphosphamide same dose every 2 weeks; preds 20mg/msq eod every 2nd week with cyclophosphamide. After 6 months vincristine and cyclophosphamide every 3 weeks; preds on alternate days every 3 weeks same week as the cyclophosphamide (all same dose rates).

IME cats are pretty resistant to side effects like bone marrow suppression and sterile cystitis from the cyclophosphamide but still do a blood count before each dose.

This is what I've always done and it also pretty well verbatim in the BSAVA small animal formulary - there's a body weight to surface area conversion chart in there too.

RE: Feline Sino-Nasal Lymphoma - best treatment options

Iain McAllister — Tue, 13 Dec 2016 14:46:44 GMT

Thanks - what COP protocol do you recommend as I know there are a few variants...

RE: Feline Sino-Nasal Lymphoma - best treatment options

Gerry Polton — Tue, 13 Dec 2016 13:51:19 GMT

Yup! If you are managing it yourself, it's COP for me every time. You will get a good response in about 90% of cases. The only problem for those 90% is that you should expect relapse or progression at another site around 6 months into therapy. There is evidence to support the combination of chemotherapy and radiotherapy, with a better long-term prognosis but of course with a lot more treatment to get there. I have a slowly growing body of evidence supporting a high-dose COP approach but I am not ready to recommend that to practitioners yet: there needs to be a certain amount of dose jiggery-pokery which is best managed by one experienced in these matters.

Best of luck

Gerry

RE: Feline Sino-Nasal Lymphoma - best treatment options

Martin Atkinson — Tue, 13 Dec 2016 10:58:40 GMT

I would bow to Gerry's opinion if he comes on with this one but I see no further than COP, its cheap and it works. I'm currently treating a cat with intestinal lymphoma which has been in remission for over a year on preds and cyclophosphamide alone although I realise that is a different beast.