Long-term evaluation of chlorambucil plus prednisone in the idiopathic nephrotic syndrome of childhood

The New England Journal of Medicine
S A WilliamsW E Grupe


We evaluated the long-term effects of a five to 15-week course of chlorambucil and prednisone in 59 children with idiopathic nephrotic syndrome who had previously received prednisone alone and had had frequent relapses or steroid dependency or resistance. By actuarial analysis of 65 courses of dual therapy followed up for one to 12 years (mean, 5.0), we found that 95 per cent of patients were in remission at one year and 85 per cent at four years. All but two had remissions lasting longer than those induced by steroids alone, and only eight others had one or more relapses after therapy. Life-table analysis of two dosage schedules of chlorambucil at four years showed that 91 per cent of patients on low doses and 80 per cent of those on high doses were still in remission. Although immediate complications were minimal, the potential for long-term toxicity still requires careful selection of patients who receive chlorambucil. Prolonged use of chlorambucil in daily doses above 0.3 mg per kilogram of body weight per day or cumulative doses above 14 mg per kilogram is no longer warranted. Measured in terms of both the immediate and long-term responses, chlorambucil appears to lower the frequency of relapses in idiopathic nephrotic syn...Continue Reading


Feb 1, 1978·The Journal of Pediatrics·H J BaluarteA B Gruskin
Sep 1, 1978·The Journal of Pediatrics·S A WilliamsW E Grupe
Nov 1, 1976·Pediatric Clinics of North America·C P RanceJ W Balfe
Jan 6, 1977·The New England Journal of Medicine·C KleinknechtM Broyer
Sep 30, 1976·The New England Journal of Medicine·W E GrupeJ R Ingelfinger
Apr 1, 1973·The Journal of Pediatrics·W E Grupe
Jul 30, 1966·Lancet·J S Cameron, G Blandford
Oct 1, 1968·Archives of Disease in Childhood·C N Lam, G C Arneil
Aug 1, 1972·The Journal of Pediatrics·N J SiegelJ P Hayslett
Jun 1, 1974·American Journal of Diseases of Children·S P Makker, W Heymann
Sep 20, 1971·JAMA : the Journal of the American Medical Association·D G Miller
Dec 1, 1958·Journal of Chronic Diseases·S J CUTLER, F EDERER
Apr 24, 1958·Annals of the New York Academy of Sciences·C A DOANB A BOURONCLE


Jan 1, 1991·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·A Y ElzoukiO P Jaiswal
Jul 1, 1988·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·D P JonesR J Wyatt
Sep 1, 1990·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·A Y Elzouki, O P Jaiswal
Jan 1, 1982·Indian Journal of Pediatrics·M Chandra
Jul 1, 1988·Indian Journal of Pediatrics·K K KherM Sweet
Mar 8, 2008·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Viktória SümegiSándor Túri
Oct 12, 2012·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Rebecca M LombelElisabeth M Hodson
May 1, 1986·The Journal of Laryngology and Otology·H DommerbyS Hancke
Jun 16, 1999·Kidney International. Supplement·J M Bargman
Feb 25, 1982·The New England Journal of Medicine·Arbeitsgemeinschaft für Pädiatrische Nephrologie
Jul 29, 1982·The New England Journal of Medicine
Jun 1, 1990·The British Journal of Ophthalmology·H H Tessler, T Jennings
Jun 1, 2012·Kidney International Supplements
Jun 1, 1986·Kidney International·F NolascoD G Williams
Aug 19, 2003·Pharmacotherapy·Renee F RobinsonDonald L Batisky
Jan 1, 1986·The Journal of Pediatrics·R N SrivastavaU N Bhuyan
Feb 1, 1987·The American Journal of Medicine·M Schwartzman, V D'Agati
Dec 3, 1990·Cancer Letters·A CavaliereR Vitali
May 1, 1992·Clinical Pediatrics·N BesbasA Bakkaloglu
Mar 21, 2018·Journal of the American Animal Hospital Association·Akira MurakamiTakashi Mori
May 1, 1988·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·R H WiesnerE R Dickson
Apr 10, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Pietro RavaniGian Marco Ghiggeri

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