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Prognostication of Canine T Cell Lymphoma

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Title: Prognostication of Canine T Cell Lymphoma
Author: Deravi, Nariman
Department: Department of Pathobiology
Program: Veterinary Science
Advisor: Bienzle, Dorothee
Abstract: Canine lymphoma is a heterogeneous disease with many different subtypes. T cell lymphoma (TCL) is variable in outcome, and includes subtypes with non-progressive, indolent and aggressive disease course. Methods used to categorize lymphoma including cytopathology, flow cytometry, histopathology, and immunochemistry. Many different classification schemes have been used in the past, however, currently an adaptation of the human World Health Organization (WHO) classification is proposed. This classification categorizes lymphoma based on cytopathology, flow cytometry, histopathology, immunohistochemistry, and molecular techniques. Association of immunotype and subtype with disease course is incompletely defined. The goal of this study was to associate immunotype and different WHO subtypes with prognosis. Retrospectively, flow cytometric immunotyping for 127 canine TCL were analyzed in relation to survival and progression free interval. Samples originated from 101 multicentric, 8 mediastinal, 6 cutaneous, 5 hepatosplenic, 5 gastrointestinal and 2 other anatomic subtypes of TCL. Compared to patients with multicentric TCL, those with gastrointestinal lymphoma had shorter survival and progression free interval, and those with hepatosplenic lymphoma had shorter progression free interval. Among patients with multicentric TCL, immunotypes of CD4+/CD8-/MHCII+, CD4-/CD8+/MHCII+ and CD4-/CD8+/MHCII- were associated with longer survival than the CD4+/CD8-/MHCII- immunotype, and immunotypes of CD4+/CD8-/MHCII+, CD4-/CD8+/MHCII+, and CD4-/CD8-/MHCII+ were associated with longer progression free intervals. Prospectively, cytopathological, flow cytometric, histopathological, and immunohistochemical data was collected from 16 patients. Samples included 8 peripheral T cell Lymphoma – not otherwise specified (PTCL-NOS), 6 T zone lymphomas (TZL), and 2 T lymphoblastic lymphomas (T LBL). Both aggressive and indolent forms were identified in the PTCL-NOS and T LBL categories with unique immunotypes consistent with the retrospective study. TZL were always indolent and had consistent immunotypes. MHC class II expression was associated with favourable prognosis. Grading based on mitoses or Ki67 expression did not significantly affect outcome. Interobserver agreement was non-existent for cytopathology and flow cytometry, and moderate for histopathology and immunohistochemistry. There is support for the judicious use of single agent or no chemotherapy for TCL.
Date: 2017-11
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