All feline diagnoses

Your cat was diagnosed with Multicentric Lymphoma. Rare in cats compared to dogs. Peripheral lymphadenopathy is an uncommon presentation of feline lymphoma (contrast with canine where it is the most common). Often associated with FeLV/FIV infection. Compare 5 treatment options for cats including COP or CHOP Protocol, Prednisolone Monotherapy, Lomustine (CCNU) Rescue — with survival times, costs, and what to expect during treatment.

🐈

Multicentric Lymphoma

multicentric

feline

Round Cell

About This Cancer

Multicentric lymphoma — the form characterised by widespread enlargement of peripheral lymph nodes — is actually uncommon in cats, in contrast to dogs where it is the most frequent presentation of lymphoma. In cats, this form is often associated with feline leukaemia virus (FeLV) or feline immunodeficiency virus (FIV) infection. Affected cats develop enlarged lymph nodes that can be felt under the jaw, in front of the shoulders, or behind the knees. The disease may also involve internal organs including the liver and spleen. Treatment typically follows chemotherapy protocols similar to those used in canine lymphoma, and many cats achieve initial remission, though FeLV-positive cats generally have a shorter response and poorer overall prognosis than FeLV-negative cats.

WHO Modified Staging for Feline Lymphoma

Standard staging system.

Stage ISingle node/area
Stage IIMultiple nodes, same side of diaphragm
Stage IIIBoth sides of diaphragm
Stage IVLiver/spleen involvement
Stage VBone marrow/blood involvement
Prognostic Factors(4)
FeLV statusFeLV-positive cats have significantly decreased remission times and overall survival. FeLV-positive MST likely <3 months with chemotherapy. FeLV-negative cats may achieve MST 6-12 months. FeLV status is arguably the single most important prognostic factor for feline multicentric lymphoma.(Mooney et al., 1989; Vail et al., 1998)
SubstageSubstage b (systemic signs: weight loss, anorexia, fever) associated with worse outcomes
FIV statusFIV-positive cats with lymphoma may have intermediate prognosis. Less well-characterised than FeLV impact.
ImmunophenotypeB-cell vs T-cell phenotype may influence prognosis but insufficient multicentric-specific data to quantify impact
Minimum Workup(8 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.
2CBC, comprehensive chemistry panel
3FeLV/FIV testing (critical — most multicentric lymphoma in cats is retrovirus-associated)
4Peripheral lymph node FNA cytology
5Thoracic radiographs
6Abdominal ultrasound
7Bone marrow aspirate (staging)
8Immunophenotyping

Median Survival Time Comparison

How long the average patient survives with each treatment

Bar opacity reflects evidence strength
COP or CHOP Protocol
~6 mo (2–12)
Prednisolone Monotherapy
~1.5 mo (1–3)
Lomustine (CCNU) Rescue
See notes
Single-Agent Doxorubicin Rescue
See notes
Protocol Switch (COP↔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.