Mali Walks Away in Full Remission

Big celebrations at EVS – Mali is our first chemo graduate!

Mali is now in clinical remission from lymphoma and we could not be more proud to be celebrating with her!

Patient: Mali, Female American Pit Bull Mix

Presentation: Mali’s owner started to notice swollen lymph nodes on her neck in late January 2023. At a visit with her primary care veterinarian, a fine needle aspirate was performed and cytology came back as large cell lymphoma on February 1, 2023.

Diagnostics: With this diagnosis, Mali was referred to Evolution Veterinary Specialists‘ oncologist, Dr. Sam Hocker. Based solely on physical examination, Mali appeared to have at least Stage III lymphoma; however, further diagnostics for staging would need to be performed to verify this stage (abdominal U/S and thoracic radiographs were declined by the owner.) Immunophenotype was unknown at that time and flow cytometry was declined by the owner. Both stage and immunophenotype can provide prognostic information; however, they currently do not alter the proposed treatment plan for canine lymphoma. Mali was histologically diagnosed with a mast cell tumor in September 2022. MCT was excised. Given the recent diagnosis of lymphoma, the plan is to focus on lymphoma; however, given a 30% chance of developing another MCT, monitoring will be necessary for any new MCT developments.

Treatment: Treatment plans proposed to the owner included a 19-week CHOP protocol, single-agent doxorubicin, and prednisone alone. CHOP protocol for B-cell lymphoma generally has an ORR of ~85-90% and an MST of ~12 months. CHOP for T-cells is roughly 75-80% ORR with MST of 6-9 months. Single-agent doxorubicin has ~ 85-90% response rate for both immunophenotypes, but MST is ~5-8 months. Prednisone alone provides MST of about 1-3 months.

Outcome: Mali is currently on week 16 of the 19-week protocol and continues to remain in complete remission. Her owner states that she has more energy and appetite now than she’s had in years and continues to experience minimal side effects from chemotherapy. As long as she remains in clinical remission, Mali will continue through the rest of her CHOP protocol.