Chemotherapy protocols for lymphoma: ferrets
Note: the suggested protocols are based on clinical application and case studies and extrapolated from other species; there are no primary controlled trials in ferrets. A CBC should be performed prior to the administration of any chemotherapeutic agents.
Option 1
| Week | Day | Drug | Dose and route |
|---|---|---|---|
| 1 | 1 | Prednisolone | 1–2 mg/kg p.o. q12h continued throughout course of therapy |
| Vincristine | 0.025 mg/kg i.v. | ||
| 3 | Cyclophosphamide | 10 mg/kg p.o., s.c. | |
| 2 | 8 | Vincristine | 0.025 mg/kg i.v. |
| 3 | 15 | Vincristine | 0.025 mg/kg i.v. |
| 4 | 22 | Vincristine | 0.025 mg/kg i.v. |
| 24 | Cyclophosphamide | 10 mg/kg p.o., s.c. | |
| 7 | 46 | Cyclophosphamide | 10 mg/kg p.o., s.c. |
| 9 | 63 | Prednisolone | Taper dose down gradually to 0 over the next 4 wks |
Option 2
| Week | Drug | Dose and route |
|---|---|---|
| 1 | Vincristine | 0.025 mg/kg i.v. |
| L-Asparginase a | 400 IU/kg intraperitoneal | |
| Prednisolone | 1 mg/kg p.o. q24h continued throughout course of therapy | |
| 2 | Cyclophosphamide | 10 mg/kg p.o., s.c. |
| 3 | Doxorubicin | 1 mg/kg i.v. |
| 4 | Vincristine | 0.025 mg/kg i.v. |
| 5 | Cyclophosphamide | 10 mg/kg p.o., s.c. |
| 6 | Doxorubicin | 1 mg/kg i.v. |
| 8 | Vincristine | 0.025 mg/kg i.v. |
| 10 | Cyclophosphamide | 10 mg/kg p.o., s.c. |
| 12 | Vincristine | 0.025 mg/kg i.v. |
| 14 | Methotrexate | 0.5 mg/kg i.v. |
a Premedicate with diphenhydramine at 1–2 mg/kg i.m. 30 minutes prior to administration to prevent an anaphylactic response.
Option 3 a
| Week | Drug | Dose and route |
|---|---|---|
| −3 | L-Asparginase b | 400 IU/kg s.c. |
| 1 | Vincristine | 0.12 mg/kg i.v. |
| Prednisolone | 1 mg/kg p.o. q24h continued throughout course of therapy | |
| Cyclophosphamide | 10 mg/kg p.o. | |
| 2 | Vincristine | 0.12 mg/kg i.v. |
| 3 | Vincristine | 0.12 mg/kg i.v. |
| 4, 7, 10, 13, etc. (q3wks) | Vincristine | 0.12 mg/kg i.v. |
| Cyclophosphamide | 10 mg/kg p.o. | |
| Rescue | Doxorubicin b | 1–2 mg/kg i.v. slow infusion |
aAntinoff N and Hahn K (2004) Ferret oncology: diseases, diagnostics and therapeutics. Veterinary Clinics of North America: Exotic Animal Practice 7, 579–625
bPremedicate with diphenhydramine at 1–2 mg/kg i.m., s.c. 30 minutes prior to administration to prevent an anaphylactic response.
Option 4 (avoiding i.v. route) 1
| Week | DRUG | Dose and route |
|---|---|---|
| 1 | L-Asparginase a | 10,000 IU/m2 s.c. |
| Cyclophosphamide | 250 mg/m2 p.o., s.c. (in 50 ml/kg NaCl s.c.) | |
| Prednisolone | 2 mg/kg p.o. q24h for 7 days then q48h throughout course of therapy | |
| 2 | L-Asparginase a | 10,000 IU/m2 s.c. |
| 3 | L-Asparginase a | 10,000 IU/m2 s.c. |
| Cytosine arabinoside | 300 mg/m2 s.c. q24h for 2 days (dilute 100 mg in 1 ml sterile water) | |
| 4 | L-Asparginase a | 10,000 IU/m2 s.c. |
| 5 | Cyclophosphamide | 250 mg/m2 p.o., s.c. (in 50 ml/kg NaCl) |
| 7 | Methotrexate | 0.8 mg/kg i.m. |
| 9 | Cyclophosphamide | 250 mg/m2 p.o., s.c. (in 50 ml/kg NaCl) |
| 11 | Cytosine arabinoside | 300 mg/m2 s.c. q24h for 2 days (dilute 100 mg in 1 ml sterile water) |
| Chlorambucil | 1 tablet/ferret p.o. | |
| 13 | Cyclophosphamide | 250 mg/m2 p.o., s.c. (in 50 ml/kg NaCl) |
| 15 | Procarbazine | 50 mg/m2 p.o. q24h for 14 days |
| 18 | Cyclophosphamide | 250 mg/m2 p.o., s.c. (in 50 ml/kg NaCl) |
| 20 | Cytosine arabinoside | 300 mg/m2 s.c. q24h for 2 days (dilute 100 mg in 1 ml sterile water) |
| 23 | Cyclophosphamide | 250 mg/m2 p.o., s.c. (in 50 ml/kg NaCl) |
| 26 | Procarbazine | 50 mg/m2 p.o. q24h for 14 days |
| 28 | Repeat weeks 20–26 if not in remission for 3 cycles |
Note:perform a CBC at weeks 2, 4, 7, 8, 12, 16, 17 and 27; if severe myelosuppression, reduce dose by 25% for subsequent treatments of the previously used drug.
aPremedicate with diphenhydramine at 1–2 mg/kg i.m., s.c. 30 minutes prior to administration to prevent an anaphylactic response.
1Antinoff N and Williams BH (2012) Neoplasia. In: Ferrets, Rabbits and Rodents, ed. KE Quesenberry and JW Carpenter, pp. 103>121. Elsevier Saunders, Missouri