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2017 ; 2017
(ä): 1757940
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Pulsed Vincristine Therapy in Steroid-Resistant Nephrotic Syndrome
#MMPMID28630858
Thalgahagoda S
; Abeyagunawardena S
; Jayaweera H
; Karunadasa UI
; Abeyagunawardena AS
Biomed Res Int
2017[]; 2017
(ä): 1757940
PMID28630858
show ga
Steroid-resistant nephrotic syndrome (SRNS) poses a therapeutic challenge for the
paediatric nephrologist. As relentless progression to renal failure occurs with
continued proteinuria, such patients will be treated with different cytotoxic
medications with variable success rates and side-effects. We present here our
findings on administering the anticancer drug vincristine for SRNS patients at a
single centre in Sri Lanka. Methods. Between 2002 and 2007, fifty-four children
presenting with steroid and cyclophosphamide resistance were treated with
vincristine at 1.5?mg/m(2) in weekly intravenous pulses for 8 weeks along with a
tapering steroid regimen of 6 months. All patients were closely followed up for 5
years. Results. Of the 54 patients 39 were males and 15 were females (age range
3.5-11.6 years, median 6.1 years). At the end of the treatment course, 21
patients achieved complete remission while 7 had partial remission and no
response was seen in 26 patients. Sustained remission at 6, 12, 24, and 60 months
were 15 (27.78%), 11 (20.37%), 9 (16.67%), and 7 (12.96%), respectively. Most
side-effects observed were reversible and no serious side-effects were noted
during vincristine therapy. Conclusion. Although its therapeutic mechanisms in
nephrotic syndrome are still not elucidated, vincristine appears to be a potent
alternative that could be considered for treating SRNS.