LOPH and D-MHC in the treatment of FeLV associated acute leukemia in a cat

Background: Bone marrow primary malignancies are denominated leukemias, classified as myeloid or lymphoid, according to the cell lineage, and acute or chronic, according to the cell´s state of maturation. In cats, acute lymphoid leukemiais the most common form, especially in regions endemic for feline leukemia virus and / or feline immunodeficiency virus.A new treatment protocol for lymphomas, called LOPH, was described for animals with FeLV persistent viremia. Thisstudy aimed to report a case of a cat presenting with FeLV associated acute leukemia and treated with the LOPH protocol,and, in the rescue phase, a modification of the D-MAC protocol, denominated D-MHC.Case: A 4-year-old mixed breed intact queen was attended due to lethargy and inappetence. The patient did not present anyrelevant abnormalities in the clinical exam and complementary exams were performed including complete blood count,biochemical profile, SNAP Feline Triple Test, chest radiographs and abdominal ultrasound. Imaging tests and biochemicalvalues were unremarkable, but the patient presented a reagent result for FeLV and severe leukocytosis due to lymphocytosis. The morphological evaluation of the blood smear revealed the presence of blasts, in a concentration greater than 20%of the nucleated cells, which allowed the characterization of a leukemic state, probably lymphoid. First-line treatmentwas based on the LOPH protocol, including Lomustine, Vincristine, Prednisolone and Doxorubicin, in four-week cycles.Nevertheless, during the third cycle, 66 days after the institution of this protocol, the patient presented a febrile conditionalong with marked leukocytosis due to lymphocytosis, confirming leukemia recurrence. A rescue attempt was performedwith a modification of the D-MAC protocol, originally consisting of the combination of dexamethasone, melphalan, actinomycin-D and cytarabine, but with replacement of actinomycin-D by doxorubicin, and therefore denominated D-MHC....(AU)

Neuropatia periférica focal associada ao linfoma em cães / Focal peripheral neuropathy associated with lymphoma in dogs

Background: Peripheral neuropathies result in sensory, motor or autonomic dysfunctions due to impairment of peripheral spinal or cranial nerves. Neoplasms such as lymphoma are cited as one of the many aetiological causes and it mayaffect the nerve directly, by compression, or indirectly (paraneoplastic) by remote action of the neoplasm located in anextra-neural site. This study aimed to report two cases of cranial nerve neuropathy (trigeminal and facial) associated withcanine lymphoma, contributing to a better understanding of its paraneoplastic effects on the nervous system, as well asthe diagnosis and treatment of these conditions.Cases: Two cases of canine lymphoma associated with possible signs of paraneoplastic peripheral neuropathy were attendedat the Veterinary Hospital from the Universidade Federal de Minas Gerais (HV UFMG). Case 1. A spayed mixed breedbitch, with lethargy and unilateral exophthalmos. Brain computed tomography revealed a retrobulbar mass and cytology wasdiagnostic for extranodal lymphoma. Subsequent to computed tomography, the dog was presented with hypotrophy of thefacial musculature and difficulty in grasping food, consistent with trigeminal nerve palsy, which resolved after institutionof the 19-week chemotherapy protocol from the University of Wisconsin. Nevertheless, disease reccurred and a rescueprotocol was initiated. Case 2. A female Dalmatian, spayed, was diagnosed with multicentric lymphoma, after cytologyof the left mandibular lymph node. Chemotherapy was initiated with the same protocol of the previous case. However,the disease progressed and it was observed facial asymmetry with ptosis of the left eyelid, pina and lips, in addition todifficulty in grasping food, suggesting facial and trigeminal cranial nerve palsy. Clinical signs resolved after institutionof a rescue chemotherapy protocol. However, in both cases, disease progression and poor clinical condition resulted in...(AU)

Neuropatia periférica focal associada ao linfoma em cães / Focal peripheral neuropathy associated with lymphoma in dogs

Background: Peripheral neuropathies result in sensory, motor or autonomic dysfunctions due to impairment of peripheral spinal or cranial nerves. Neoplasms such as lymphoma are cited as one of the many aetiological causes and it mayaffect the nerve directly, by compression, or indirectly (paraneoplastic) by remote action of the neoplasm located in anextra-neural site. This study aimed to report two cases of cranial nerve neuropathy (trigeminal and facial) associated withcanine lymphoma, contributing to a better understanding of its paraneoplastic effects on the nervous system, as well asthe diagnosis and treatment of these conditions.Cases: Two cases of canine lymphoma associated with possible signs of paraneoplastic peripheral neuropathy were attendedat the Veterinary Hospital from the Universidade Federal de Minas Gerais (HV UFMG). Case 1. A spayed mixed breedbitch, with lethargy and unilateral exophthalmos. Brain computed tomography revealed a retrobulbar mass and cytology wasdiagnostic for extranodal lymphoma. Subsequent to computed tomography, the dog was presented with hypotrophy of thefacial musculature and difficulty in grasping food, consistent with trigeminal nerve palsy, which resolved after institutionof the 19-week chemotherapy protocol from the University of Wisconsin. Nevertheless, disease reccurred and a rescueprotocol was initiated. Case 2. A female Dalmatian, spayed, was diagnosed with multicentric lymphoma, after cytologyof the left mandibular lymph node. Chemotherapy was initiated with the same protocol of the previous case. However,the disease progressed and it was observed facial asymmetry with ptosis of the left eyelid, pina and lips, in addition todifficulty in grasping food, suggesting facial and trigeminal cranial nerve palsy. Clinical signs resolved after institutionof a rescue chemotherapy protocol. However, in both cases, disease progression and poor clinical condition resulted in...

LOPH and D-MHC in the treatment of FeLV associated acute leukemia in a cat

Background: Bone marrow primary malignancies are denominated leukemias, classified as myeloid or lymphoid, according to the cell lineage, and acute or chronic, according to the cell´s state of maturation. In cats, acute lymphoid leukemiais the most common form, especially in regions endemic for feline leukemia virus and / or feline immunodeficiency virus.A new treatment protocol for lymphomas, called LOPH, was described for animals with FeLV persistent viremia. Thisstudy aimed to report a case of a cat presenting with FeLV associated acute leukemia and treated with the LOPH protocol,and, in the rescue phase, a modification of the D-MAC protocol, denominated D-MHC.Case: A 4-year-old mixed breed intact queen was attended due to lethargy and inappetence. The patient did not present anyrelevant abnormalities in the clinical exam and complementary exams were performed including complete blood count,biochemical profile, SNAP Feline Triple Test, chest radiographs and abdominal ultrasound. Imaging tests and biochemicalvalues were unremarkable, but the patient presented a reagent result for FeLV and severe leukocytosis due to lymphocytosis. The morphological evaluation of the blood smear revealed the presence of blasts, in a concentration greater than 20%of the nucleated cells, which allowed the characterization of a leukemic state, probably lymphoid. First-line treatmentwas based on the LOPH protocol, including Lomustine, Vincristine, Prednisolone and Doxorubicin, in four-week cycles.Nevertheless, during the third cycle, 66 days after the institution of this protocol, the patient presented a febrile conditionalong with marked leukocytosis due to lymphocytosis, confirming leukemia recurrence. A rescue attempt was performedwith a modification of the D-MAC protocol, originally consisting of the combination of dexamethasone, melphalan, actinomycin-D and cytarabine, but with replacement of actinomycin-D by doxorubicin, and therefore denominated D-MHC....