ISSN 2398-2950      

Leukemia

ffelis

Synonym(s): Myeloproliferative, lymphoproliferative disease


Introduction

  • One third of all feline neoplasms are hematopoietic.
  • Definition: malignant proliferation of lymphoid or myeloid cells originating from the bone marrow +/- circulating in peripheral blood. Some lymphoid leukemia can also originate from the spleen.
  • Both myeloproliferative and lymphoproliferative diseases, classified as acute versus chronic and by cell lines affected (see below).
  • Signs: non-specific, due to consequences of disease process, eg cytopenia, hypercalcemia.
  • Diagnosis: peripheral blood smears, bone marrow aspirate/biopsy, flow cytometry, PCR for antigen rearrangement (PARR).
  • Treatment: supportive, symptomatic, specific cytotoxic agents depending on type of leukemia.
  • Prognosis: favorable in chronic forms, poor in acute.
Print off the owner factsheet on Feline leukaemia to give to your client.

Pathogenesis

Etiology

  • Unknown. Genetic factors, environmental factors, radiation and chemical exposure should be considered.
  • Viral: 60-80% of acute lymphoid leukemias are FeLV Feline leukemia virus disease positive - may be association between FIV Feline immunodeficiency virus disease and myeloproliferative disease.
  • A 2019 study showed a high association between FeLV infection and feline leukemias in Brazil.

Pathophysiology

  • Neoplastic transformation of cells involved in hematopoiesis   →   massive proliferation of neoplastic cells.
  • Transformation of stem cells or early precursors   →   proliferation of immature cells incapable of maturation   →  acute leukemia  →   large numbers of immature cells in bone marrow and peripheral blood   →   severe non-regenerative cytopenia   →   may result in bleeding (thrombocytopenia), sepsis (neutropenia), profound weakness and lethargy (anemia).
  • Disseminated intravascular coagulation   →   bleeding diathesis.
  • Transformation of late precursor cells   →   proliferation of mature, differentiated cells   →  chronic leukemia  →   less severe cytopenia.
  • Excessive numbers of circulating cells/hyperproteinemia   →   hyperviscosity   →   decreased oxygen transport to capillary beds   →   microthrombi of tumor cells.
  • Production of humoral factors   →   stimulation of osteoclasts   →   hypercalcemia of malignancy   →   renal failure.

Timecourse

  • Acute leukemia progresses rapidly over days/weeks.
  • Chronic leukemia over months/years.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Tagawa M, Shimbo G, Watanabe K I, Horiuchi N, Kobayashi Y, Maezawa M, Matsumoto K, Miyahara K (2020) Acute monoblastic leukemia in a feline leukemia virus-negative cat. J Vet Med Sci 82(7), 1000-1005 PubMed
  • Cristo T G, Biezus G, Noronha L F, Gaspar T, Dal Pont T P, Withoeft J A, Furlan L V, Costa L S, Traverso S D, Casagrande R A (2019) Feline Leukaemia Virus Associated with Leukaemia in Cats in Santa Catarina, Brazil. J Comp Pathol 170, 10-21 PubMed.  
  • Tomiyasu H, Doi A, Chambers J K, Goto-KoshinoY, Ohmi A, Ohno K, Tsujimoto H (2018) Clinical and clinicopathological characteristics of acute lymphoblastic leukaemia in six cats. J Small Anim Pract 259(12), 742-746 PubMed.  
  • Mochizuki H, Seki T, Nakahara Y, Tomita A, Takahashi M, Fujino Y, Ohno K,Tsujimoto H (2014) Chronic myelogenous leukaemia with persistent neutrophilia, eosinophilia and basophilia in a cat. J Feline Med Surg 16(6), 517-521 PubMed.  
  • Campbell M W, Hess P R, Williams L E (2013) Chronic lymphocytic leukaemia in the cat: 18 cases (2000-2010). Vet Comp Oncol 11(4), 256-264 PubMed
  • Fischer C, Tan E, Bienzle D (2012) Erythroleukemia in a retrovirus-negative cat. J Am Vet Med Assoc 240(3), 294-297 PubMed.  
  • Shirani D, Nassiri S M, Aldavood S J, Seddigh H S, Fathi E (2011) Acute erythroid leukemia with multilineage dysplasia in a cat. Can Vet J 52(4), 389-393 PubMed
  • Hisasue M, Nagashima N, Nishigaki K, Fukuzawa I, Ura S, Katae H, Tsuchiya R, Yamada T, Hasegawa A, Tsujimoto H (2009) Myelodysplastic syndromes and acute myeloid leukemia in cats infected with feline leukemia virus clone33 containing a unique long terminal repeat. Int J Cancer 124(5), 1133-1141 PubMed
  • Dobson J, Villiers E & Morris J (2006) Diagnosis and management of leukaemia in dogs and cats. In Practice 28 (1), 22-31 VetMedResource.
  • Nagashima N, Kano R, Hirai A, Yamazaki J, Inoue C, Hisasue M, Moore P F, Hasegawa A (2005) Acute monocytic leukaemia in a cat. Vet Rec 157(12), 347-9 PubMed
  • Weiss D V (2005) Differentiating benign and malignant causes of lymphocytosis in feline bone marrow. J Vet Intern Med 19(6), 855-859 PubMed.
  • Workman H C, Vernau W (2003) Chronic lymphocytic leukemia in dogs and cats: the veterinary perspective. Vet Clin North Am Small Anim Pract 33(6), 1379-1399 PubMed.  
  • Shimoda T, Shiranaga N, Mashita T et al (2000) Chronic myelomonocytic leukemia in a cat. J Vet Med Sci 62 (2), 195-197 PubMed.
  • Breuer W, Hermanns W & Thiele J (1999) Myelodysplastic syndrome (MDS), acute myeloid leukaemia (AML) and chronic myeloproliferative disorder (CMPD) in cats. J Comp Pathol 121 (3), 203-216 PubMed.
  • Gasper P W, Rosen D K, Fulton R (1996) Allogeneic marrow transplantation in a cat with acute myeloid leukemia. J Am Vet Med Assoc 208(8),1280-1284 PubMed
  • Shimada T,  Matsumoto Y, Okuda M,  Momoi Y, Bonkobara M, Watari T, Goitsuka R, Ono K,  Goto N, Tsujimoto H et al (1995) Erythroleukemia in two cats naturally infected with feline leukemia virus in the same household. J Vet Med Sci 57(2),199-204 PubMed
  • Bounous D I , Latimer K S, Campagnoli R P, Hynes P F (1994) Acute myeloid leukemia with basophilic differentiation (AML, M-2B) in a cat. Vet Clin Pathol 23(1),15-18 PubMed.  
  • Jain N C, Blue J T, Grindem C B, Harvey J W, Kociba G J, Krehbiel J D, Latimer K S, Raskin R E, Thrall M A, Zink J G (1991) Proposed criteria for classification of acute myeloid leukemia in dogs and cats. Vet Clin Pathol 20(3), 63-82 PubMed.  
  • Grindem C B, Perman V & Stevens J B (1985) Morphological classification and clinical and pathological characteristics of spontaneous leukemia in 10 cats. JAAHA 21 (2), 227-236 VetMedResource.
  • Henness A M, Crow S E (1977) Treatment of feline myelogenous leukemia: four case reports. J Am Vet Med Assoc 171(3), 263-266 PubMed
  • Gilmore C E & Holzworth J (1971) Naturally occurring feline leukemia clinical, pathological and differential diagnostic features. JAVMA 158 (6), 1013 PubMed.
  • Holzworth J (1960) Leukemia and related neoplasms in the cat. 1. Lymphoid malignancies. JAVMA 136, 47-69 PubMed.

Other sources of information

  • Vail D M, Pinkerton M, Young K M (2020) Cancer chemotherapy. In: Small Animal Clinical Oncology. 6th edn. Eds Withrow & MacEwen. Elsevier Saunders, St. Louis. pp 729-730.
  • Ward H & Couto C G (1997) Myeloid leukemia. In: Consultations in Feline Internal Medicine 3.pp 509-513.
  • Sherding R G (1994) In: The Cat - diseases and Clinical Management. Ed R G Sherding. 2nd edition. New York: Churchill Livingstone. pp 789-796.

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