High-Cost Benefit of Chlorambucil in Frequently Relapsing Nephrosis

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Abstract
To the Editor: Grupe et al. (N Engl J Med 295:746, 1976) demonstrated the beneficial effect of chlorambucil in frequently relapsing nephrosis. Despite their excellent results and the good tolerance of the drug, the authors gave strong advice against the wide use of chlorambucil because of its potential toxicity. Our data afford further evidence of both the efficacy and the toxicity of the drug. Sixty-two children with frequent relapsing nephrosis who received chlorambucil were followed for more than one year after withdrawal of the drug. Initial dosage was 0.2 mg per kilogram per day in 45 patients and 0.1 . . .