All canine diagnoses

Your dog was diagnosed with Multicentric B-Cell Lymphoma. Most common haematopoietic neoplasm in dogs, representing ~24% of all canine neoplasms. Estimated incidence 20-107 per 100,000 dogs per year. B-cell phenotype accounts for 60-80% of cases. Compare 7 treatment options for dogs including CHOP Protocol (UW-Madison 25-week), COP Protocol, Single-Agent Doxorubicin — with survival times, costs, and what to expect during treatment.

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Multicentric B-Cell Lymphoma

WHO Stage III-V

BreedsGolden RetrieverBoxerBullmastiffBernese Mountain DogRottweilerScottish TerrierDoberman Pinscher
canine

Round Cell

About This Cancer

Lymphoma is a cancer of white blood cells called lymphocytes, which are a key part of the immune system. In multicentric B-cell lymphoma, the malignant cells are B-lymphocytes — the type normally responsible for producing antibodies. The disease typically causes rapid, painless enlargement of lymph nodes throughout the body, which is why it is called 'multicentric.' It is the most common blood-cell cancer in dogs and one of the most frequently diagnosed canine cancers overall. Without treatment, the disease progresses quickly, with a typical survival of just four to six weeks. With chemotherapy, however, most dogs achieve remission, and the B-cell subtype generally responds better to treatment and carries a more favourable prognosis than T-cell lymphoma. Certain breeds, including Golden Retrievers, Boxers, and Bernese Mountain Dogs, are more frequently affected.

WHO Clinical Staging for Canine Lymphoma

Five-stage system based on extent of lymph node and organ involvement, with substage a (asymptomatic) or b (symptomatic).

Stage ISingle lymph node or single extranodal site involvement
Stage IIMultiple lymph nodes in a regional area (ipsilateral)
Stage IIIGeneralised lymph node involvement
Stage IVLiver and/or spleen involvement (with or without Stage III)
Stage VBlood, bone marrow, or non-lymphoid organ involvement
Prognostic Factors(5)
ImmunophenotypeB-cell lymphoma carries significantly better prognosis than T-cell, with MST approximately double (12-14 months vs 6-9 months with CHOP)(Garrett et al., 2002)
SubstageSubstage b (systemic signs: fever, weight loss, anorexia) associated with shorter survival than substage a(Rassnick et al., 2021)
HypercalcaemiaParaneoplastic hypercalcaemia (more common in T-cell) is a negative prognostic indicator
Ki-67 proliferation indexHigher Ki-67 (>20 positive cells per grid area) associated with shorter survival. Cutoff of 12.2% differentiates low vs high grade
Prior steroid usePre-treatment corticosteroids may induce multi-drug resistance (MDR) and reduce chemotherapy response
Minimum Workup(10 steps)
1CRITICAL WARNING: Avoid administering prednisolone/prednisone BEFORE obtaining biopsy/cytology — corticosteroids can induce multi-drug resistance (MDR) and cause rapid tumour lysis, making subsequent histopathological diagnosis difficult or impossible. Complete diagnostic workup BEFORE starting any corticosteroid therapy.
2Fine-needle aspirate of enlarged lymph node with cytology
3Flow cytometry or immunohistochemistry for immunophenotyping (B vs T cell)
4Complete blood count with differential
5Serum biochemistry panel including calcium
6Thoracic radiographs (3 views)
7Abdominal ultrasound
8Bone marrow aspirate (if substage b or suspected Stage V)
9Urinalysis
10MDR1/ABCB1 pre-treatment genotyping for at-risk breeds (Collie, Shetland Sheepdog, Australian Shepherd, Old English Sheepdog, and related breeds) — vincristine dose reduction required in homozygous mutant dogs

Median Survival Time Comparison

How long the average patient survives with each treatment

Bar opacity reflects evidence strength
CHOP Protocol (UW-Madison 25-week)
~11 mo (10–14)
COP Protocol
~6.5 mo (6–9)
Single-Agent Doxorubicin
~7.6 mo (5.5–10)
Prednisone Monotherapy
~1.7 mo (1.4–2)
Alternating Rabacfosadine + Doxorubicin
See notes
L-Asparaginase Induction (CHOP Adjunct)
See notes
Metronomic Maintenance post-CHOP
See notes
Reading this page: MST (Median Survival Time) is how long the average patient survives with a given treatment. ORR (Overall Response Rate) is the percentage of patients whose tumour shrank or disappeared. CR = Complete Response (tumour gone); PR = Partial Response (tumour shrank). Hover over any abbreviation for a quick explanation.
Strength of Evidence

Each treatment is rated by how much published research supports its use. Solid bars indicate stronger evidence; dashed bars mean less certainty.

StrongLarge published studies with strong agreement among veterinary oncologists.
ModerateWidely used in clinical practice, but supported by smaller or retrospective studies.
IndirectEvidence comes from a different tumour type or species and has been applied here.
LimitedVery little published data is available for this specific treatment.

Please note: All treatment data is sourced from published peer-reviewed literature. Survival times and cost figures are approximate guides. Your pet's individual factors — including tumour grade, stage, and overall health — will influence outcomes and should guide all treatment decisions. The strength-of-evidence rating reflects how much research exists, not how strongly a treatment is recommended. This tool is designed to help you have informed conversations with your veterinary oncologist, not to replace them. Costs shown are US referral centre estimates and may vary significantly by region.