Chlorambucil in steroid-dependent nephrotic syndrome

• Published in: The Journal of pediatrics Vol. 82; no. 4; pp. 598 - 606
• Main Author: Grupe, Warren E.
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.04.1973
• Subjects: Adolescent; Beta-Globulins - analysis; Blood Pressure - drug effects; Child; Child, Preschool; Chlorambucil - administration & dosage; Chlorambucil - adverse effects; Chlorambucil - therapeutic use; Drug Synergism; Female; Growth Disorders - chemically induced; Humans; Leukopenia - chemically induced; Male; Nephrotic Syndrome - drug therapy; Prednisone - administration & dosage; Prednisone - adverse effects; Prednisone - therapeutic use; Proteinuria - drug therapy; Recurrence; Remission, Spontaneous
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(73)80584-0

Chlorambucil has been used in combination with prednisone in the treatment of 23 children with steroid-dependent nephrotic syndrome. Many patients had signs of steroid toxicity, and growth retardation was striking in nearly half of the children at the time chlorambucil was started. Treatment was maintained for 2 1/2 to 12 weeks until leukopenia was induced. In all children, complete remissions lasting up to 4 7/12 years have followed treatment with chlorambucil. Subsequent relapses requiring further prednisone therapy have been seen in only 13 per cent, with a follow-up of 7 months to 5 3/4 years (average 26.6 months). Complications have been minimal and there have been no deaths. These results appear to indicate that chlorambucil, when used as an adjunct to prednisone, provides effective therapy in nephrotic chidren who have responded initially to corticosteroids but who have frequent relapses or are dependent on steroid therapy to maintain remissions.