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Background  Prechemotherapy absolute neutrophil count ( ANC ) cutoffs are arbitrary and vary across institutions and clinicians. Similarly, subjective guidelines are utilized for the administration of prophylactic antibiotics in neutropenic dogs.    Objectives  To evaluate the impact of various  ANC  cutoffs on chemotherapy administration in dogs with lymphoma treated with  CHOP  chemotherapy and to determine whether an association between prechemotherapy  ANC  and subsequent toxicity exists. The secondary objective was to evaluate a currently used  ANC  cutoff to indicate prescription of prophylactic antibiotics.    Animals  Dogs diagnosed with lymphoma treated with  CHOP  chemotherapy (n = 64).    Methods  Six hundred and fifteen  ANC s were stratified into 6 classes. The 3  ANC  cutoffs 1.5 × 10 3 /μL, 2.0 × 10 3 /μL, and 2.5 × 10 3 /μL were assessed. The presence of an association between prechemotherapy  ANC  class and toxicity was determined. Afebrile neutropenic dogs with  ANC  <1.5 × 10 3 /μL but above the criteria for prophylactic antibiotics were evaluated.    Results  Chemotherapy was not administered in 7% of visits with an  ANC  cutoff of 1.5 × 10 3 /μL; chemotherapy would not have been administered in 10% and 16% of visits with an  ANC  cutoff of 2.0 × 10 3 /μL or 2.5 × 10 3 /μL, respectively. There was no association among the 3 lower prechemotherapy  ANC  classes and toxicity. All dogs with  ANC  0.75–1.5 × 10 3 /μL recovered spontaneously without medical intervention.    Conclusion and Clinical Importance  The number of dose delays was minimized with a prechemotherapy  ANC  cutoff of 1.5 × 10 3 /μL, and the prechemotherapy  ANC  class 1.5–1.99 × 10 3 /μL was not associated with an increased toxicity. Further investigation of an  ANC  cutoff near 0.75 × 10 3 /μL in which to prescribe prophylactic antibiotics is indicated.

Impact of Pretreatment Neutrophil Count on Chemotherapy Administration and Toxicity in Dogs with Lymphoma Treated with CHOP Chemotherapy