A randomized trial of methylprednisolone and chlorambucil in idiopathic membranous nephropathy

Article Abstract:

Idiopathic membranous nephropathy is a common disease of unknown origin that affects the glomeruli, the microscopic structures of the kidney which are responsible for filtering the blood. The condition is also associated with lung cancer. The current report details the statistical results of long-term therapy in a group of 81 patients (including untreated control subjects) over a 6-month period with a combined drug therapy composed of a steroid drug, methylprednisolone, and an antineoplastic chemotherapeutic drug, chlorambucil. All of the patients included in this study had their diagnosis confirmed by microscopic examination of small biopsy samples of their kidneys. The patients were followed from a period of 2 to 11 years after treatment, with a 5-year average. At the last follow-up examination, 23 percent of the untreated and 67 percent of the treated group were free of symptoms attributable to the nephrotic syndrome. A highly significant improvement in kidney function (as determined by creatinine level) was also found in the group of treated patients, when compared with the untreated controls. A six-month treatment with a combined therapy of methylprednisolone and chlorambucil can result in sustained remission of this disease and can preserve adequate kidney function in these patients. The treatment is well tolerated and no major toxic effects were noted.

Case studies, Nephrotic syndrome

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Methylprednisolone plus chlorambucil as compared with methylprednisolone alone for the treatment of idiopathic membranous nephropathy

Article Abstract:

Patients with idiopathic membranous nephropathy have an earlier remission of symptoms when methylprednisolone is used with chlorambucil than with methylprednisolone alone. Patients treated with the combination for six months had remission earlier. Earlier and therefore longer remission in the disease may protect patients from the cardiovascular diseases associated with kidney disease. There was no difference in the rate of decline in renal function in the four years after treatment began. However, the total amount of decline was less in patients receiving both drugs.

Health aspects

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Chlorambucil in indolent chronic lymphocytic leukemia

Article Abstract:

Chlorambucil does not appear to prolong the lives of patients with early-stage chronic lymphocytic leukemia (CLL). Researchers assigned 1,535 patients with stage A CLL to daily or intermittent treatment with chlorambucil, chlorambucil and prednisone, or no treatment. Chlorambucil slowed the progression of the blood disease, but did not improve survival. Delaying treatment of CLL spares patients the side effects and complications of treatment.

Chronic lymphocytic leukemia

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