This protocol is included here to give some idea of the complexity of treatment - check on the latest recommendations before treating any animals!
Vincristine 0.7mg/m2 iv on day 1
Cyclophosphamide 50mg/m2 po on days 1,2 3, & 4
Prednisone 1mg/kg po twice daily
Repeat induction therapy for 8 weeks. Precede each vincristine injection with a WBC and platelet count. Skip a week's treatment if WBC count is below 3x109/L, neutrophil count is below 2x109/Lor platelet count is below 100x109/L. Start prophylactic trimethoprim / sulphonamide if neutrophil count is below 1x109/L.
Vincristine 0.7mg/m2 iv every 3 weeks
Chlorambucil 2 - 4mg/m2 po on days 1,2,3 & 4 every week
Prednisone 1mg/kg po every second day
Continues until the 52nd week of treatment or until the lymphoma comes out of remission.
When the animal comes out of remission (usually due to tumour resistance) a change of drugs is required to regain remission. The second period of remission is usually shorter than the first period. The treatment required to obtain a second remission is usually more expensive. An alternative approach is to use late intensification of therapy after sucessful induction but before tumour recrudescence. Late intensification has some theoretical support as an effective strategy. It is also practical in veterinary medicine because by the time the owner is asked to consider more expensive and potentially more toxic drugs, much of their fear of chemotherapy has evaporated. Consider the following drugs for rescue or late intensification. Doxorubicin is the most effective rescue drug.
Doxorubicin 30mg/m2 iv every 3 weeks for 3 - 6 treatments (max 8 treatments) or cytarabine 100mg/m2 iv on days 1,2,3 & 4 repeated every 3 weeks for 2 - 3 treatments or vinblastine 2.5mg/m2 iv every week for 6 treatments
Given with or without asparaginase 400iu/kg sc or ip weeky for 1 - 3 treatments
