Madison Wisconsin lymphoma protocol

From Dog

The Madison Winsconsin lymphoma protocol is a chemotherapy regimen[1].

Week 1:

Week 2:

  • Cyclophosphamide 250 mg/m2 PO or IV (+ NaCl)
  • Prednisolone 1.5 mg/kg PO SID
  • Stop antacids: after week 2

Week 3:

  • Vincristine 0.7 mg/m2 IV
  • Prednisolone 1 mg/kg PO SID

Week 4:

  • Doxorubicin 30 mg/m2 IV (+ 0.9% NaCl) - for dogs < 10 Kg, use 1 mg/Kg dose of doxorubicin
  • Pre-med with chlorphenamine and
  • Metoclopramide 0.5-1 mg/kg IM/SC
  • Prednisolone 0.5 mg/kg PO SID

Week 6:

  • Vincristine 0.7 mg/m2 IV

Week 7:

  • Cyclophosphamide 250 mg/m2 PO or IV (+ NaCl)

Week 8:

  • Vincristine 0.7 mg/m2 IV

Week 9:

  • Doxorubicin 30 mg/m2 IV (+ 0.9% NaCl)
  • Pre-med with chlorphenamine + metoclopramide

Week 11:

  • Vincristine 0.7 mg/m2 IV

Week 13:

  • Cyclophosphamide 250 mg/m2 PO or IV (+ NaCl)

Week 15:

  • Vincristine 0.7 mg/m2 IV

Week 17:

  • Doxorubicin 30 mg/m2 IV (+ 0.9% NaCl)
  • Pre-med with chlorphenamine + metoclopramide

Week 19:

  • Vincristine 0.7 mg/m2 IV

Week 21:

  • Cyclophosphamide 250 mg/m2 PO or IV (+ NaCl)

Week 23:

  • Vincristine 0.7 mg/m2 IV

Week 25:

  • Doxorubicin 30 mg/m2 IV (+ 0.9% NaCl)
  • Pre-med with chlorphenamine + metoclopramide

Haematology should be performed prior to each dose and urinalysis after every cyclophosphamide dose. A full urinalysis should be performed after week 7.

A cardiac echocardiogram should be performed at the time of first and last doxorubicin dose.

All treatment is discontinued after week 25 if in complete remission.

If neutrophil count is < 3 × 109/L wait 5-7 days and repeat haematology before giving chemo.

If sterile haemorrhagic cystitis occurs on cyclophosphamide, discontinue and substitute Chlorambucil (1.4 mg/kg PO) for subsequently scheduled cyclophosphamide injections.

Administer L-asparaginase (400 IU/kg IM) with each vincristine injection until clinical remission is achieved.

References

  1. Spugnini EP et al (2011) Lansoprazole as a rescue agent in chemoresistant tumors: a phase I/II study in companion animals with spontaneously occurring tumors. J Transl Med 9:221