In order to determine the long-term effects of cyclophosphamide (CPO) and to identify parameters associated with sustained remission, we retrospectively studied the data from 90 patients with steroid-dependent nephrotic syndrome (SDNS) who received a single course of oral cyclophosphamide (2 mg/kg/day for 10 to 12 weeks). The median follow-up period after CPO was years (interquartile range -). Sustained remission reached the cumulative rate of 57% at 1 year, 42% at 2 years, and 31% at 5 years. For the patients who relapsed, the median threshold dose of prednisone between CPO initiation and first relapse has significantly decreased ( mg/kg/day versus mg/kg/day, p
Immune dysregulation associated with SLE leads to a substantially high background risk of infection. This risk of infection further increases with the use of immunosuppressive drugs like cyclophosphamide. Our objective was to determine the incidence and types of infections (especially pneumocystis jirovecii (PCJ) ) in SLE patients treated with cyclophosphamide, and to identify relative contribution of other variables like patient demographics, steroid dose, other immunosuppressive agents, baseline white blood cell(WBC) count and absolute neutrophil count(ANC) to the risk of infection.
Nine ( %) patients had recurrences 3 weeks to 8 months later. Of these 6 had oral recurrences. Five of these 9 recurrences occurred with withdrawal of corticosteroid (after a mean period of months), three after tapering of prednisolone to 10 mg/day, and one with missed cyclophosphamide pulses. Recurrences were managed as described above, and cleared in eight out of the nine patients at a mean of 2 months (range 1- months) from their onset, and had not cleared in one patient at the time of analysis. Three of these eight patients developed a second recurrence at 1- months after clearance of the first, which were again managed as above.