Lomustine for treatment of feline lymphoma

Dutelle AL, Bulman-Fleming JC, Lewis CA and Rosenberg MP. Evaluation of lomustine as a rescue agent for cats with resistant lymphoma. J Feline Med Surg. 2012; 14: 694-700.
 
Treating cases of resistant lymphoma is very challenging for veterinarians. The study reported here evaluated the use of lomustine as a rescue agent for 39 cases of resistant lymphoma in cats. The aims of the study were to evaluate lomustine as a rescue agent in this scenario, to determine prognostic factors for progression-free interval, and to detail toxicities noted in the course of the study. Progression-free interval (PFI) was defined as the time from when a cat was placed on lomustine to subsequent progression of disease necessitating a protocol change or euthanasia. The different parameters evaluated were lymphocyte cell size, number of previous chemotherapy drugs and number of chemotherapy protocols received, time from lymphoma diagnosis to initiation of lomustine therapy, body weight, and anatomic location of lymphoma.

The results demonstrated that the significant prognostic factors for PFI were cell size, number of previous chemotherapeutic drugs, number of previous chemotherapeutic protocols, and anatomic location. Cats with large cell lymphoma were 9.8 times more likely to have disease progression. Twenty-one cats (54%) received more than 1 dose of lomustine. Cats that had received 3 to 4 prior protocols were 3.6 times more likely to have disease progression than cats receiving 1 or 2 prior protocols. And cats with non-GI lymphoma were 4.7 times more likely to have progression of disease as ones with GI lymphoma. The most commonly noted toxicities in this study were vomiting, diarrhea, thrombocytopenia, leukopenia, and elevated ALT. It was noted that strict monitoring of the CBC while cats are on this drug is very important. [VT]

See also: Musser ML, Quinn HT and Chretin JD. Low apparent risk of CCNU (lomustine)-associated clinical hepatotoxicity in cats. J Feline Med Surg. 2012; 14: 871-5.

Related blog articles:
Pulmonary fibrosis in a cat receiving lomustine (July 2008)
Treatment for mast cell tumors in cats (April 2008)

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Dutelle AL, Bulman-Fleming JC, Lewis CA and Rosenberg MP. Evaluation of lomustine as a rescue agent for cats with resistant lymphoma. J Feline Med Surg. 2012; 14: 694-700.
 
Treating cases of resistant lymphoma is very challenging for veterinarians. The study reported here evaluated the use of lomustine as a rescue agent for 39 cases of resistant lymphoma in cats. The aims of the study were to evaluate lomustine as a rescue agent in this scenario, to determine prognostic factors for progression-free interval, and to detail toxicities noted in the course of the study. Progression-free interval (PFI) was defined as the time from when a cat was placed on lomustine to subsequent progression of disease necessitating a protocol change or euthanasia. The different parameters evaluated were lymphocyte cell size, number of previous chemotherapy drugs and number of chemotherapy protocols received, time from lymphoma diagnosis to initiation of lomustine therapy, body weight, and anatomic location of lymphoma.

The results demonstrated that the significant prognostic factors for PFI were cell size, number of previous chemotherapeutic drugs, number of previous chemotherapeutic protocols, and anatomic location. Cats with large cell lymphoma were 9.8 times more likely to have disease progression. Twenty-one cats (54%) received more than 1 dose of lomustine. Cats that had received 3 to 4 prior protocols were 3.6 times more likely to have disease progression than cats receiving 1 or 2 prior protocols. And cats with non-GI lymphoma were 4.7 times more likely to have progression of disease as ones with GI lymphoma. The most commonly noted toxicities in this study were vomiting, diarrhea, thrombocytopenia, leukopenia, and elevated ALT. It was noted that strict monitoring of the CBC while cats are on this drug is very important. [VT]

See also: Musser ML, Quinn HT and Chretin JD. Low apparent risk of CCNU (lomustine)-associated clinical hepatotoxicity in cats. J Feline Med Surg. 2012; 14: 871-5.

Related blog articles:
Pulmonary fibrosis in a cat receiving lomustine (July 2008)
Treatment for mast cell tumors in cats (April 2008)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

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Pulmonary Fibrosis in a Cat Receiving Lomustine

Skorupski, K. A., A. C. Durham, et al. (2008). "Pulmonary fibrosis after high cumulative dose nitrosourea chemotherapy in a cat." Veterinary and Comparative Oncology 6(2): 120-125.

Lomustine (CCNU) is an alkylating nitrosourea chemotherapy drug. In feline medicine, it has been used for cutaneous lymphoma and mast cell tumors. Neutropenia and thrombocytopenia are known complications, so close monitoring of blood cell parameters is necessary during treatment. In this case report, a cat diagnosed with alimentary lymphoma did poorly on several chemotherapeutic regimes. However, a long-term remission was achieved with lomustine and corticosteroid therapy. After 12 months of therapy, the cat died after an acute episode of respiratory distress. On post mortem examination, severe diffuse pulmonary fibrosis was identified. The cat had no previous history of pulmonary disease. This is the first report of pulmonary fibrosis following high cumulative dose nitrosourea chemotherapy in a cat.
>> Article Abstract

Related articles
Blog post: Lomustine for mast cell tumors in cats

More on cat health: Winn Feline Foundation Library

Skorupski, K. A., A. C. Durham, et al. (2008). "Pulmonary fibrosis after high cumulative dose nitrosourea chemotherapy in a cat." Veterinary and Comparative Oncology 6(2): 120-125.

Lomustine (CCNU) is an alkylating nitrosourea chemotherapy drug. In feline medicine, it has been used for cutaneous lymphoma and mast cell tumors. Neutropenia and thrombocytopenia are known complications, so close monitoring of blood cell parameters is necessary during treatment. In this case report, a cat diagnosed with alimentary lymphoma did poorly on several chemotherapeutic regimes. However, a long-term remission was achieved with lomustine and corticosteroid therapy. After 12 months of therapy, the cat died after an acute episode of respiratory distress. On post mortem examination, severe diffuse pulmonary fibrosis was identified. The cat had no previous history of pulmonary disease. This is the first report of pulmonary fibrosis following high cumulative dose nitrosourea chemotherapy in a cat.
>> Article Abstract

Related articles
Blog post: Lomustine for mast cell tumors in cats

More on cat health: Winn Feline Foundation Library

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Treatment for Mast Cell Tumors in Cats

Rassnick, K. M., L. E. Williams, et al. (2008). "Lomustine for treatment of mast cell tumors in cats: 38 cases (1999-2005)." J Am Vet Med Assoc 232(8): 1200-5.


Mast cell tumours (MCTs) are commonly diagnosed in cats, particularly in cutaneous locations. These tumours have a range of biological behavior from benign to malignant. Most cutaneous MCTs are readily treated with surgery or local radiation. Alternative treatments are needed for those cats where surgery or radiation is not an option, or where these modalities have failed to prevent recurrence. In this retrospective case series, the clinical efficacy and toxicity of lomustine was evaluated in 38 cats with confirmed mast cell tumors. Lomustine was administered at a dose at or equal to 50 mg/m(2). Of the 38 cats, most (68%) had cutaneous MCTs but tumors were also diagnosed in other locations, such as mesenteric lymph nodes. The overall response rate was 50%, with 7 cats having a complete response. The median duration of response was 168 days. The most commonly noted toxicoses were neutropenia and thrombocytopenia. The researchers conclude that lomustine should be considered for cats with MCTs where local treatment is not an option.
>> PubMed abstract


Related articles:
Turrel, J., J. Farrelly, et al. (2006). "Evaluation of strontium 90 irradiation in treatment of cutaneous mast cell tumors in cats: 35 cases (1992-2002)." J Amer Vet Med Assoc 228(6): 898-901.
>> PubMed abstract


More on cat health: Winn Feline Foundation Library

Rassnick, K. M., L. E. Williams, et al. (2008). "Lomustine for treatment of mast cell tumors in cats: 38 cases (1999-2005)." J Am Vet Med Assoc 232(8): 1200-5.


Mast cell tumours (MCTs) are commonly diagnosed in cats, particularly in cutaneous locations. These tumours have a range of biological behavior from benign to malignant. Most cutaneous MCTs are readily treated with surgery or local radiation. Alternative treatments are needed for those cats where surgery or radiation is not an option, or where these modalities have failed to prevent recurrence. In this retrospective case series, the clinical efficacy and toxicity of lomustine was evaluated in 38 cats with confirmed mast cell tumors. Lomustine was administered at a dose at or equal to 50 mg/m(2). Of the 38 cats, most (68%) had cutaneous MCTs but tumors were also diagnosed in other locations, such as mesenteric lymph nodes. The overall response rate was 50%, with 7 cats having a complete response. The median duration of response was 168 days. The most commonly noted toxicoses were neutropenia and thrombocytopenia. The researchers conclude that lomustine should be considered for cats with MCTs where local treatment is not an option.
>> PubMed abstract


Related articles:
Turrel, J., J. Farrelly, et al. (2006). "Evaluation of strontium 90 irradiation in treatment of cutaneous mast cell tumors in cats: 35 cases (1992-2002)." J Amer Vet Med Assoc 228(6): 898-901.
>> PubMed abstract


More on cat health: Winn Feline Foundation Library

Read More