From:
williams@ex-pressnet.com
Date: 2001-03-13 13:29:00 UTC
Subject: Re: Prognosis in Leukemia
I am familiar with this protocol. Unfortunately, there is little talk of a
remission or cure, especially when the neoplasm is leukemic (meaning that
the neoplastic cells are in the bloodstream), then the cases are extremely
difficult.
The biggest problem with leukemia is that the cells are not only in the
bloodstream, but they are also in the bone marrow as well. In high numbers,
they crowd out the cells that normally produce blood elements - RBC, white
blood cells, and platelets - so on top of the neoplasm, these animals often
develop a life-threatening anemia. When you add chemotherapeutic agents on
top fo this to kill the neoplastic cells, you may further depress normal
bone marrow output - as you might surmise, not a high rate of success.
right now, judging from the data, the RBC's appear okay, but the platelets
are on the low side. This may pick up as occasionally vincristine has been
used to increase platelet function in some cases.
Overall, sustained response to chemo is probably seen in less than 10% -
most animals survive 2-4 months, but in all truth, that high a white counts
does not bode well even for that short period of time. I'm keeping my
fingers crossed, but I always give a poor prognosis in any case of
lymphoma,and I am rarely proved wrong.
With kindest regards,
Bruce Williams, DVM, DACVP
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****************************
Dr. Williams, sorry to impose, but Max is my fourth ferret to come down
with lymphosarcoma, and we are trying chemo. A modification of the U. of
Wisconsin protocol - are you familiar with it ? I have been trying to
contact help thru the new Ferret Health List Website for ten days now,
but it keeps listing me as a guest and says I haven't been approved yet,
and can't post, but time is short.
Max is a 2 -3 year old neutered male. I adopted him from a local ferret
rescue almost a year ago (I am a member). No info available on his
origins or prior care except that he was in good condition when
surrendered, and an initial check-up after the adoption was normal
(including CBC). A week ago he was running and wrestling with the best
of them, suddenly became lethargic. I checked him over, found his
abdomen was totally taken over by his spleen, rushed him to the vet.
His initial WBC count was 79,730, with over 77% lymphs, many smudge
cells and a few immature forms (blasts) Platelets 134,000, HGB 15.2,
RBCs 9.0 X 10^6, MCV 48.3, retics 0.2%.
He has had the first course of treatment - vincristine, followed by
asparaginase and Pred. Then two more agents will be introduced, for a
total of 10 weeks then "we'll see". Is there any hope - does anyone talk
of remission or cure, with a white count this high? Any way to determine
a prognosis, how long he might live ? Right now he continues to be very
lethargic (probably the chemo and cell destruction), but is eating. He
is also on Pred, Clavamox and Carafate.
As you can imagine, I am devastated. The first three went very quickly
(weeks) but they only had Pred. By the way, the first three were
Marshall Farms, but this one was most likely not (no tattoos). I would
appreciate any advice. I know you don't want to second guess my vet, but
if you could give us any idea of his chances, or if any particular
regimen has shown promise in ferrets, she would definitely look into it.
She is always looking for better ways to treat her patients, very open
to new avenues to explore.