, Volume 21, Issue 4, p 597
Date: 21 Feb 2006

Is there a role for vincristine in nephrotic syndrome?

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Sirs,

The recent report by Kausman et al. on the effect of vincristine on 12 children with steroid-dependent nephrotic syndrome [1] is the third retrospective publication on this subject in Pediatric Nephrology [2, 3] and brings the number of children reported to 27. As in the previous reports, Kausman’s patients had already been treated with steroids and cyclophosphamide; ten had also received cyclosporin. One of Kausman’s patients achieved long-term remission, bringing the total reported to 5/27. They also record an increase in the mean duration of remissions from 3 months to 8 months.

We can add a further 17 patients to this group. Nine had steroid resistance, of whom eight had focal segmental glomerulosclerosis (FSGS), and eight had steroid dependence, of whom three had FSGS, the remainder having minimal lesion. The median (range) age was 5.3 (1.2 to 14.4) years, and 11 were boys. All 17 had received previous treatment with steroids, 12/17 with cyclophosphamide, and 4/17 with levamis ...