Chlorambucil treatment in minimal lesion nephrotic syndrome: A reappraisal of its gonadal toxicity

Callı́s, L; Nieto, Jorge M.; Vila, Amparo Marquina; Rende, J.

doi:10.1016/s0022-3476(80)80035-7

Cited by 54 publications

(6 citation statements)

References 14 publications

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“…In long term follow up, cyclophosphamide appears to be safe in terms of gonadal function in males and females in a cumulative dose of up to 500 mg/kg.22 23 For chlorambucil, a dose of less than 10 mg/kg seems to be safe whereas a dose of more than 18 mg/kg caused azoospermia in all boys. 24 The effects of sequential treatment with cyclophosphamide and chlorambucil are not known. More worrying are observations about the development of malignancies in nephrotic children after cytotoxic treatment.…”

Section: Discussionmentioning

confidence: 99%

Alternative treatment to corticosteroids in steroid sensitive idiopathic nephrotic syndrome.

Neuhaus¹,

Fay²,

Dillon³

et al. 1994

Archives of Disease in Childhood

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Section: Discussionmentioning

confidence: 99%

Alternative treatment to corticosteroids in steroid sensitive idiopathic nephrotic syndrome.

Neuhaus¹,

Fay²,

Dillon³

et al. 1994

Archives of Disease in Childhood

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“…Pregnancies were reported after cumulative doses of 182-525 mg/kg CYC [70,84,99,105]. Callis et al [90] reported normal pubertal development in ten female adolescents after CHL therapy with cumulative doses of 9-28 mg/kg.…”

Section: Gonadal Toxicitymentioning

confidence: 99%

A meta-analysis of cytotoxic treatment for frequently relapsing nephrotic syndrome in children

Latta

Schnakenburg

Ehrich

2001

Pediatric Nephrology

217

145

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For over 30 years cyclophosphamide (CYC) and chlorambucil (CHL) have been used to treat children with relapsing steroid-sensitive nephrotic syndrome (SSNS). A meta-analysis on treatment protocols, efficacy, and side effects of CYC and CHL was performed from the literature. Thirty-eight studies comprising 1,504 children and 1,573 courses of cytotoxic drug therapy were systematically evaluated. Relapse-free survival rates increased with the cumulative dosage of CHL and CYC and were higher in children with frequently relapsing than steroid-dependent NS. The fatality rate of the treatment was approximately 1%. Leukopenia occurred in one-third of patients treated with either drug. Severe bacterial infections developed in 1.5% of the patients under CYC and in 6.8% under CHL. Seizures were observed in 3.6% of children treated with CHL. Malignancies were observed in 14 children after high doses of either drug. Females rarely developed permanent gonadal damage. However, no safe threshold for a cumulative amount of CYC was found in males, but there was a marked increase in the risk of oligo- or azoospermia with higher cumulative doses. From this meta-analysis we recommend CYC 2-3 mg/kg body weight for 8-12 weeks as the standard scheme. CHL has higher rates of severe side effects and should be considered a second-line drug.

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“…Örneğin, klorambusil ile 14 yıl tedavi edilen bir hastada kemoterapiden sonraki 15 yıl boyunca azoosperminin devam ettiği, dolayısıyla spermatogenesisin çok uzun süre sonra normale dönebildiği bildirilmektedir (97). Öte yandan nefrotik sendromlu prepubertal ve pubertal dönemdeki erkeklerin klorambusil ile tedavisinden sonra hastaların pek çoğunda testiküler hipotrofi, serum FSH düzeyinde artış, azoospermi ve bir hastada da şiddetli oligospermi gözlendiği rapor edilmiştir (98,99). Benzer şekilde Thomson ve ark.…”

Section: Kanserli Erkeklerdeki Etkileriunclassified

Kemoterapötiklerin erkek üreme sistemi üzerindeki yan etkileri ve koruyucu stratejiler

Türk¹

2013

mpj

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Chlorambucil treatment in minimal lesion nephrotic syndrome: A reappraisal of its gonadal toxicity

Cited by 54 publications

References 14 publications

Alternative treatment to corticosteroids in steroid sensitive idiopathic nephrotic syndrome.

Alternative treatment to corticosteroids in steroid sensitive idiopathic nephrotic syndrome.

A meta-analysis of cytotoxic treatment for frequently relapsing nephrotic syndrome in children

Kemoterapötiklerin erkek üreme sistemi üzerindeki yan etkileri ve koruyucu stratejiler

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