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Cyclophosphamide treatment in steroid-sensitive nephrotic syndrome of childhood
Lancet (London, England)
|January 11, 1975
Insights
Cyclophosphamide treatment for childhood nephrotic syndrome shows long-term remission rates of 69% at 1 year and 44% at 4 years. This chemotherapy is more effective in older children and those receiving it during steroid-maintained remission.
Area of Science:
- Pediatric Nephrology
- Clinical Pharmacology
- Immunosuppressive Therapy
Background:
- Steroid-sensitive nephrotic syndrome (SSNS) is a common kidney disease in children.
- Relapses are frequent, necessitating long-term management strategies.
- Identifying effective and durable treatments is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of cyclophosphamide in children with SSNS.
- To determine remission rates and factors influencing treatment success.
- To assess the role of cyclophosphamide as an alternative to prolonged corticosteroid use.
Main Methods:
- An 8-week course of cyclophosphamide (3 mg/kg/day) was administered to 82 children with SSNS.
- Patients were monitored for remission and relapse rates over a 4-year period.
- Subgroup analyses were performed based on age and concurrent steroid use.
Main Results:
- One patient died during the study period.
- Remission rates were 69% at 1 year and 44% at 4 years post-treatment.
- Older children and those treated during steroid-maintained remission demonstrated significantly better outcomes.
Conclusions:
- Cyclophosphamide can achieve durable remission in a substantial proportion of children with SSNS.
- Treatment timing and patient age are important prognostic factors for cyclophosphamide efficacy.
- This immunosuppressive agent offers a potential long-term therapeutic option for managing childhood nephrotic syndrome.
Abstract:
An 8-week course of 3 mg. per kg. body-weight per day of cyclophosphamide was administered to eighty-two children with steroid-senstitive nephrotic syndrome. One died, and of the remainder, 69% were in remission after 1 year and 44% after 4-years. Older children and those in whom cyclophosphamide was given during a steroid-maintained remission fared better.