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Pediatric Nephrology

, Volume 12, Issue 4, pp 284–289 | Cite as

Vincristine and focal segmental sclerosis: do we need a multicentre trial?

  • Chulananda D. A. Goonasekera
  • Ania B. Koziell
  • Sally A. Hulton
  • Michael J. Dillon
Clinical nephrology, Original article

Abstract.

Over the last 10 years, eight children have received vincristine for the treatment of steroid- and cyclophosphamide-resistant nephrotic syndrome at Great Ormond Street Hospital for Children, London. We present our experience of these eight cases and put forward a case for reassessing the effectiveness of vincristine in this disorder. In our series, two children treated with vincristine achieved complete remission with preserved renal function, including relapses in one. Both had primary steroid- and cyclophosphamide-resistant focal segmental glomerulo sclerosis (FSGS). Of the other cases, four also had primary FSGS, one familial FSGS and one mesangioproliferative glomerulonephritis. We discuss in general the pros and cons of vincristine therapy in nephrotic syndrome versus the cytotoxic agents that are currently used and the differences in clinical features among the responders and non-responders in this small group. In addition, we explore why this may have occurred and summarise the literature over the last 25 years, where vincristine appeared to have been beneficial, especially in secondary forms of nephrotic syndrome associated with malignancy. We conclude that vincristine therapy warrants re-examination as it could be a valuable alternative therapeutic agent in some cases of FSGS with relatively minor side effects.

Key words: Focal segmental glomerulosclerosis Vincristine therapy 

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Copyright information

© IPNA - International Pediatric Nephrology Association New York, USA 1998

Authors and Affiliations

  • Chulananda D. A. Goonasekera
    • 1
  • Ania B. Koziell
    • 1
  • Sally A. Hulton
    • 2
  • Michael J. Dillon
    • 1
  1. 1.Institute of Child Health and Great Ormond Street Children’s Hospital NHS Trust, 30 Guilford Street, London WC1 N1EH, UKGB
  2. 2.Department of Nephrology, The Birmingham Children’s Hospital NHS Trust, Ladywood, Middleway, Birmingham B16 8ET, UKGB

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