A retrospective evaluation of lomustine (CeeNU) in 32 treatment naïve cats with intermediate to large cell gastrointestinal lymphoma (2006–2013)

Abstract

Multi-drug chemotherapy protocols for feline lymphoma have demonstrated variable efficacy and tolerability. In phase I trials, lomustine has demonstrated efficacy for cats with lymphoma though its use for treatment naïve feline intermediate/large cell gastrointestinal (GI) lymphoma remains unknown. This study evaluated the efficacy and tolerability of lomustine for the treatment of feline GI lymphoma. Thirty-two cats with histologically or cytologically confirmed intermediate/large cell GI lymphoma were evaluated retrospectively. Factors assessed included clinical signs, hematologic/biochemical parameters and use of l-asparaginase at induction. A response rate of 50% (16/32), with median duration of response of 302 days (range 64-1450 days), was found. Median progression-free interval was 132 days (range 31-1450 days), with overall median survival time of 108 days (range 4-1488 days). History of hyporexia, presence of anaemia and dose of lomustine were significantly associated with progression-free survival. Overall, lomustine is a well-tolerated and effective treatment for feline GI lymphoma.

Outcomes in 40 cats with discrete intermediate‐ or large‐cell gastrointestinal lymphoma masses treated with surgical mass resection (2005‐2015)

“…The overall survival times in this study are comparable to those reported for cats with GI LSA treated with systemic chemotherapy alone . In addition to improving survival time, maintaining quality of life is an important goal in LSA case management because treatment is often palliative in nature.…”

“…At initial examination, medical records indicated palpation of an abdominal mass in 30 cats. Complete blood counts were available for 34 cats, and the most commonly noted abnormalities were neutrophilia (11), anemia (11), leukocytosis (10), and monocytosis (4). Blood chemistry results were available for 29 cats, and the most commonly noted abnormalities were hyperglycemia (5), hypoalbuminemia (5), hyperglobulinemia (4), hypocalcemia (4), and low blood urea nitrogen (4).…”

“…Most often, this treatment consists of COP (cyclophosphamide, vincristine, prednisolone) or CHOP (plus doxorubicin)‐based protocols. Unlike in dogs, in which multicentric LSA predominates and is overwhelmingly responsive to chemotherapy, the response to multiagent chemotherapy in cats with feline GI large‐cell LSA is less predictable, with overall response rates ranging from 30% to 75% . Response durability also tends to be less favorable, with reported median survival times (MST) of 3 to 6 months .…”

“…Unlike in dogs, in which multicentric LSA predominates and is overwhelmingly responsive to chemotherapy, the response to multiagent chemotherapy in cats with feline GI large-cell LSA is less predictable, with overall response rates ranging from 30% to 75%. [4][5][6][7][8][9][10][11] Response durability also tends to be less favorable, with reported median survival times (MST) of 3 to 6 months. 1,[4][5][6][7][8][9][10][11][12] However, MST tends to be closely linked to response to chemotherapy.…”

“…[4][5][6][7][8][9][10][11] Response durability also tends to be less favorable, with reported median survival times (MST) of 3 to 6 months. 1,[4][5][6][7][8][9][10][11][12] However, MST tends to be closely linked to response to chemotherapy. Survival time is short in cats that experience either partial or no response to medical treatment, while survival times exceeding one year are documented in cats that undergo a complete response.…”