Introduction

• The following chemotherapy protocols for lymphoma will be covered:
  • Induction protocols:
    • Modified UW-Madison (UW 25) (CHOP-based).
    • Modified LOPP.
    • Combination cytotoxic therapy COP.
    • Single - agent doxorubicin.
    • Single-agent rabacfosadine.
  • Rescue protocols:
    • CCNU + prednisolone.
    • L-asparaginase +CCNU+ prednisolone.
    • DMAC protocol.

Protocol 1: Modified UW-Madison (UW 25) (CHOP-based)

Protocol 2: modified LOPP

Protocol 3: Combination cytotoxic therapy COP

Protocol 4: Single-agent doxorubicin

Protocol 5: Single-agent rabacfosadine

Rescue protocols

Legal and safety precautions

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Saba C F, Clifford C, Burgess K, Phillips B, Vail D, Wright Z, Curran K, Fan T, Elmslie R, Post G, Thamm D (2020) Rabacfosadine for naïve canine intermediate to large cell lymphoma: Efficacy and adverse event profile across three prospective clinical trials. Vet Comp Oncol Apr 28 PubMed.
• Smallwood K, Tanis J B, Grant I A, Blackwood L, Killick D R, Amores-Fuster I, Elliott J, Mas A, Harper A, Marrington M, Finotello R (2019) Evaluation of a multi-agent chemotherapy protocol combining dexamethasone, melphalan, actinomycin D, and cytarabine for the treatment of resistant canine non-Hodgkin high-grade lymphomas: a single centre's experience. Vet Comp Oncol 17(2),165-173 PubMed. 
• Saba C F, Vickery K R, Clifford C A, Burgess K E, Phillips B, Vail D M, Wright Z M, Morges M A, Fan T M, Thamm D H (2018) Rabacfosadine for relapsed canine B-cell lymphoma: Efficacy and adverse event profiles of 2 different doses. Vet Comp Oncol 16(1), E76-E82 PubMed.
• Morgan E, O'Connell K, Thomson M, Griffin A (2018) Canine T cell lymphoma treated with lomustine, vincristine, procarbazine, and prednisolone chemotherapy in 35 dogs. Vet Comp Oncol 16(4), 622-629 PubMed. 
• Brown P M, Tzannes S, Nguyen S, White J, Langova V (2018) LOPP chemotherapy as a first-line treatment for dogs with T-cell lymphoma. Vet Comp Oncol 16(1), 108-113 PubMed. 
• Thamm D H, Vail D M, Post G S, Fan T M, Phillips B S et al (2017) Alternating Rabacfosadine/Doxorubicin: Efficacy and Tolerability in Naıve Canine Multicentric Lymphoma. J Vet Intern Med 31(3), 872-878 PubMed.
• Parsons-Doherty M, Poirier V J, Monteith G (2014) The efficacy and adverse event profile of dexamethasone, melphalan, actinomycin D, and cytosine arabinoside (DMAC) chemotherapy in relapsed canine lymphoma. Can Vet J 55(2),175-180 PubMed.
• Fahey C E, Milner R J, Barabas K, Lurie D, Kow K, Parfitt S, Lyles S, Clemente M (2011) Evaluation of the University of Florida lomustine, vincristine, procarbazine, and prednisone chemotherapy protocol for the treatment of relapsed lymphoma in dogs: 33 cases (2003-2009). J Am Vet Med Assoc 239(2), 209-215 PubMed.
• Vail D M , Thamm D H, Reiser H, Ray A S, Wolfgang G H I (2009) Assessment of GS-9219 in a Pet Dog Model of Non-Hodgkin's Lymphoma. Clin Cancer Res 15 (10), 3503-3510 PubMed.
• Saba C F, Thamm D H, Vail D M (2007) Combination chemotherapy with L-asparginase, lomustine and prednisone for relapsed or refractory canine lymphoma. J Vet Intern Med 21 (1), 127-131 PubMed.
• Simon D, Nolte I, Eberle N et al (2006) Treatment of dogs with lymphoma using a 12-week, maintenance-free combination chemotherapy protocol. J Vet Intern Med 20 (4), 948-954 PubMed.
• Alvarez F J, Kisseberth, W C, Gallant S L, Couto C G (2006) Dexamethasone, melphalan, actinomycin D, cytosine arabinoside (DMAC) protocol for dogs with relapsed lymphoma. J Vet Intern Med 20(5), 1178-1183 PubMed.
• MacDonald V S, Thamm D H, Kurzman I D et al (2005) Does L-asparaginase influence efficacy or toxicity when added to a standard CHOP protocol for dogs with lymphoma? J Vet Intern Med 19 (5), 732-736 PubMed.
• Jeffreys A B, Knapp D W, Carlton W W et al (2005) Influence of asparaginase on a combination chemotherapy protocol for canine multicentric lymphoma. JAAHA 41 (4), 221-226 PubMed.
• Vail D M & Thamm D H (2005) Cytotoxic chemotherapy: new players, new tactics. JAAHA 41 (4), 209-214 PubMed.
• Kristal O, Rassnick K M, Gliatto J M et al (2004) Hepatotoxicity associated with CCNU (lomustine) chemotherapy in dogs. J Vet Intern Med 18 (1), 75-80 PubMed.
• Brønden LB, Rutteman G R, Flagstad A et al (2003) Study of dog and cat owners' perceptions of medical treatment for cancer. Vet Rec 152 (3), 77-80 PubMed.
• Charney S C, Bergman P J, Hohenhaus A E et al (2003) Risk factors for sterile hemorrhagic cystitis in dogs with lymphoma receiving cyclophosphamide with or without concurrent administration of furosemide: 216 cases (1990-1996). JAVMA 222 (10), 1388-1393 PubMed.
• Garrett L D, Thamm D H, Chun R et al (2002) Evaluation of a 6-month chemotherapy protocol with no maintenance therapy for dogs with lymphoma. J Vet Intern Med 16 (6), 704-709 PubMed.
• Rassnick K M, Mauldin G E, Al-Sarraf R et al (2002) MOPP chemotherapy for treatment of resistant lymphoma in dogs: a retrospective study of 117 cases (1989-2000). JVIM 16 (5), 576-580 PubMed.
• Moore A S, Cotter S M, Rand W M et al (2001) Evaluation of a continuous treatment protocol (VELCAP-S) for canine lymphoma. J Vet Intern Med 15 (4), 348-354 PubMed.
• Boyce K L & Kitchell B E (2000) Treatment of canine lymphoma with COPLA/LVP. JAAHA 36 (5), 395-403 PubMed.
• Chun R, Garrett L D & Vail D M (2000) Evaluation of a high-dose chemotherapy protocol with no maintenance therapy for dogs with lymphoma. J Vet Intern Med 14 (2), 120-124 PubMed.
• Piek C J, Rutteman G R & Teske E (1999) Evaluation of the results of a L-asparaginase-based continuous chemotherapy protocol versus a short doxorubicin-based induction chemotherapy protocol in dogs with malignant lymphoma. Vet Q 21 (2), 44-49 PubMed.
• Myers N C 3rd, Moore A S, Rand W M et al (1997) Evaluation of a multi-drug chemotherapy protocol (ACOPA 11) in dogs with lymphoma. J Vet Intern Med 11 (6), 333-339 PubMed.
• Valerius K D, Oglivie G K, Mallinckrodt C H et al (1997) Doxorubicin alone or in combination with asparaginase, followed by cyclophosphamide, vincristine, and prednisone for treatment of multicentric lymphoma in dogs: 121 cases (1987-1995). JAVMA 210 (4), 512-516 PubMed.

Other sources of information

• Vail D M, Pinkerton M E, Young K M (2020) Canine lymphoma and lymphoid leukemias. In: Small animal clinical oncology. 6th edn. Eds Withrow & MacEwen’s. Elsevier Saunders, St. Louis. pp 688-715. 
• Tennant B (2002) BSAVA Small Animal Formulary, 4th edn. pp 280-281.