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[Successful treatment with fludarabine of chronic lymphocytic leukemia associated with nephrotic syndrome]
Kazuhiro Takei1, Akira Horikoshi, Yoshifumi Hosokawa
1Internal Medicine, Nihon University, Nerima-Hikarigaoka Hospital.
Insights
This study reports a successful treatment of chronic lymphocytic leukemia (CLL) with associated nephrotic syndrome using fludarabine. The therapy achieved complete remission of CLL and resolved nephrotic symptoms, highlighting fludarabine
Area of Science:
- Hematology
- Nephrology
- Oncology
Background:
- Chronic lymphocytic leukemia (CLL) is a common lymphoid malignancy.
- Nephrotic syndrome can be a rare complication of CLL.
- Management of CLL with concurrent nephrotic syndrome presents therapeutic challenges.
Observation:
- An 82-year-old male patient with diagnosed CLL developed symptoms of nephrotic syndrome, including hypoproteinemia, proteinuria, and edema.
- Symptoms of nephrotic syndrome exacerbated, necessitating hospitalization.
- The patient had been under observation for CLL for one year without prior treatment.
Findings:
- Induction therapy with fludarabine (13 mg/m2/day for 4 days) was administered for CLL.
- Fludarabine treatment resulted in a complete remission of chronic lymphocytic leukemia.
- The patient experienced complete resolution of edema, indicating successful management of the nephrotic syndrome.
Implications:
- Fludarabine demonstrated significant efficacy in treating both CLL and its associated nephrotic syndrome.
- This case represents the first reported instance in Japan of fludarabine's dramatic effectiveness in managing both conditions.
- Fludarabine may be a valuable therapeutic option for CLL patients experiencing nephrotic syndrome complications.
Abstract:
We successfully treated a patient with chronic lymphocytic leukemia (CLL) associated with a nephrotic syndrome. An 82-year-old man had been diagnosed as having CLL and been under observation for a year without treatment. In January, 2001, he developed hypoprotenemia, proteinurea, and edema in the extremities and face. With the exacerbation of the symptoms, he was admitted to our hospital in March of the same year. Under the diagnosis of nephrotic syndrome with CLL, the patient underwent induction therapy for CLL with fludarabine (13 mg/m2/day for 4 days), which brought about a complete remission of CLL and the disappearance of the edema. To our knowledge, this was the first case in Japan where fludarabine was dramatically effective in treating both CLL and the nephrotic syndrome. This result indicated that fludarabine is beneficial for not only CLL but also complications like nephrotic syndrome.
