Prednisone Chlorambucil

JourdanE, TopartD, Pinzani V, Jourdan I Chlorambucil/prednisone-induced seizures in a patient with non-Hodgkin s lymphoma. Am JHematol (2001) 67, 147. 

ChIVPP—every 28 days Chlorambucil 6 mg PO daily, days 1-14 Vinblastine 6 mg/m2 IV x 1, days 1-8 Procarbazine 100 mg PO daily, days 1-14 Prednisone 40 mg PO daily, days 1-14... 

Minimal-change disease is more common in children than in adults. It is rare in black children and adults of sub-Saharan Africa. Minimal-change responds well to steroids. However, it may recur after prednisone is decreased or discontinued. In such cases, the addition of cyclophosphamide or chlorambucil may produce a response. The GFR is normal. Progression to renal failure does not occur unless focal glomerulosclerosis is present. 

Autoimmune hemolytic anemia Prednisone,1 cyclophosphamide, chlorambucil, mercaptopurine, azathioprine, high-dose gamma globulin Usually good... 

Chronic lymphocytic leukemia Chlorambucil and prednisone (if indicated), fludarabine Allopurinol,1 doxorubicin, cladribine... 

An 80-year-old woman with a small B cell extranodal lymphoma was initially given chlorambucil for 10 months, with complete remission for 2 years. When she developed recurrent lymph node sweUing she was given ibritumomab tiuxetan, with near-complete remission. When she developed progressive disease 14 months later, she received cyclophosphamide, vincristine, and prednisone for one cycle. She had persistent pancytopenia, and a bone marrow biopsy showed extensive infiltration by acnte myelogenons lenkemia. 

ChlVPP chlorambucil, vincristine (Oncovin), procarbazine, and prednisone... 

The controversy surronnding CLL management with low-dose alkylating agents was evalnated in a meta-analysis. The results of that analysis showed that delayed treatment did not have an adverse effect on 10-year survival. If only deaths caused by CLL were considered, there was a statistically significant improvement in survival when treatment was deferred. Chlorambucil continues to be widely used in elderly patients as initial treatment for CLL, but its use is based on a small number of smdies. The addition of prednisone to chlorambucil is likely to increase infectious risk with no advantage in the treatment of CLL. However, prednisone may have value in CLL-associated autoimmnne blood dyscrasias. ... 

An isolated report describes seizures in a patient, which were possibly caused by the use of chlorambucil with prednisone. 

A patient with non-Hodgkin s lymphoma experieneed a syncopal episode with generalised tonic-clonic seizures 8 days after eompleting an initial 5-day course of treatment with chlorambucil 12 mg daily and prednisone 50 mg daily. The seizures were controlled with intravenous clonazepam. Four weeks later, on the third day of a second course, she again had generalised tonic-clonic seizures, which resolved spontaneously. 

Note that chlorambucil and prednisone or prednisolone have been widely used together. 

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