Objective: To report on the dosing, efficacy and side-effects of bolus cyclosphamide treatment for lupus nephritis (LN).
Methods: 64 consecutive cases of LN with 10 or more erythrocytes per high-power field, proteinuria (> 1 g of protein per day) and serum creatinine increased (> 133 mumol/L) were treated by bolus therapy with cyclophosphamide (CTX) given monthly for 6 months and then quarterly for 18 months.
Results: 49 patients had renal remission (defined as < 10 erythrocytes per high-power field, absence of cellular casts, excretion of < 1 g of protein per day and normal serum creatinine). The mean of doses was 1.1 g for each time (0.6-1.6 g), the mean of times of bolus CTX needed was 3.6 (1-8 times). The adverse events were amenorrhea (in 41% female patients), herpes zoster (in 13% patients) and hemorrhagic cystitis (in 1 patient).
Conclusion: The results indicate that monthly bolus CTX therapy is effective and safe for patients with LN. Its adverse effect is relatively not a serious problem.