November 2016
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CBC Quiz: The Chemotherapy Patient

CBC abnormalities can have a significant impact on treatment options for a chemotherapy patient. This quiz presents different scenarios with accompanying CBC changes that can commonly occur in patients treated with the CHOP B-cell lymphoma protocol and offers solutions on how to adapt each treatment plan accordingly.

Bear, a 7-year-old castrated golden retriever with B-cell lymphoma, is currently undergoing a CHOP-L (cyclophosphamide, hydroxyl doxorubicin, vincristine [Oncovin], prednisone, L-asparaginase) chemotherapy protocol; see Table 11 for interpretation of the neutrophil counts cited in the following scenarios.

Neutropenia Grading System1
Grade Neutrophil (/µL)
1 1500/µL to lower limit of normal (LLN)
2 1000-1499/µL
3 500-999/µL
4 <500/µL

CBC Quiz: The Chemotherapy Patient

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CHOP = cyclophosphamide, hydroxyl doxorubicin, vincristine (Oncovin), prednisolone

References and author information Show
  1. Veterinary Cooperative Oncology Group. Common terminology criteria for adverse events (VCOG-CTCAE) following chemotherapy or biological antineoplastic therapy in dogs and cats v1.1. Vet Comp Oncol. doi: 10.111/j.14765829.2011.00283.x.
  2. Dhaliwal RS. Managing oncologic emergencies: tumor and treatment-related complications. In: Henry CJ, Higginbotham ML, eds. Small Animal Cancer Management Practice. Maryland Heights, MO: Elsevier Saunders; 2010:122-135.
  3. Gustafson DL, Page RL. Cancer chemotherapy. In: Withrow SJ, Page R, Vail DM, eds. Withrow and MacEwen’s Small Animal Clinical Oncology. 5th ed. St. Louis, MO: Elsevier Saunders; 2013:157-179.
  4. Ettinger S. Unpublished observations and clinical data; VCA Animal Specialty and Emergency Centers; accumulated clinical evidence as of March 2016. 

Sue Ettinger

DVM, DACVIM (Oncology) VCA Animal Specialty & Emergency Center, Wappingers Falls, New York

Sue Ettinger, DVM, DACVIM (Oncology), is a veterinary cancer specialist currently affiliated with VCA Animal Specialty & Emergency Center of Wappingers Falls, located in the lower Hudson River Valley of New York State. Dr. Ettinger is 1 of approximately 400 board-certified veterinary specialists in medical oncology in North America. Her areas of interest focus on promoting cancer awareness and education in pets and early cancer detection and diagnosis, particularly her initiative involving skin and superficial tumors in dogs and cats called See Something, Do Something. Why Wait? Aspirate®. As part of her initiative to dispel cancer myths and misconceptions, Dr. Ettinger emphasizes comprehensive, compassionate treatments that minimize side effects and promote quality of life. Also known as Dr. Sue Cancer Vet, she is a book author (co-author of the 2nd edition of The Dog Cancer Survival Guide), radio co-host, and recognized advocate of early cancer detection and awareness in pets. She is also a certified veterinary journalist, accredited by the American Society of Veterinary Journalists. Dr. Ettinger received her DVM from Cornell University and completed a residency in medical oncology at The Animal Medical Center of New York City.

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