View Full Version : Duration of Cytoxan and remission length

08-28-2007, 10:06 AM
Does anyone have any information regarding the how the number of Cytoxan treatments affects the length of remission for lupus nephritis? I have looked all over the internet and have not been able to find any studies concerning this. It seems that the standard is once a month for six months and then intermittently after that for the next year or two. My son has had 3 infusions so far and is doing well, though not in remission yet. I am just curious if they decide to stop the infusions or not do them as frequently, will that affect the length of remission? I will ask the doctor when we see him in 2 weeks but thought maybe some of you may have some information. :)

08-28-2007, 03:27 PM
I'm not sure if anyone can answer your question, maybe if you knew how cytoxan works, it might help you?
Cells in the body divide and grow at varying rates. Examples of rapidly dividing cells include the antibody producing cells of the immune system, blood cells, hair cells, gonadal cells and malignant cells. Cytotoxic (cyto=cell, toxic=damage) drugs work by targeting and damaging cells which grow at a rapid rate. In lupus, the immune system is hyperactive and produces auto-antibodies at a rapid rate of growth. Cytotoxic medicines have their greatest effect against rapidly dividing cells and, therefore, can be beneficial in the treatment of lupus by suppressing the cells involved in the hyperactive immune response. The effect is a reduction in disease activity. There are risks associated with the use of cytotoxic drugs. The immune system may be suppressed too much and cause an increased susceptibility to infections such as shingles and pneumonia. The bone marrow may be suppressed and result in reductions in red blood cells, white blood cells and platelets. Suppression of hair cell growth may lead to a net loss of hair. The cytotoxic effects on gonadal cells may lead to sterility.
There is a lot of talk about MMF (mycophenolate mofetil; CellCept, Aspreva/Roche)being safer and more effective than Cytoxan for Lupus Nephritis. Most studies that I found were conducted by the manufacturer of MMF, so it is hard to know how valid those reports are!
Maybe someone who has used Cytoxan successfully will respond to your question. If not, please let us know what your doctor says!

Peace and Blessings

08-28-2007, 10:39 PM
I was on cytoxan for I believe 2 years, once every month then every other month, I think it helped at first and then we hit a wall and it stopped doing much. It's different for everyone though. I have heard people swear by it and I really hope it works for your son! (Nasty drug, is it not?) I don't know about remission lengths though. Sorry this post did very much NOT answer the question.

09-10-2007, 06:51 PM
I am not a doctor so I don't know for sure but I do not think the number of treatments effects the remission length. I think it is simply different drugs work better for different people. If your sons doctors decide to switch to a different medication after a while (or if you do not want him to be on it that long) it is probably because the Cytoxan is not getting the results. I also do not know exactly how active your son's disease is so that may be a factor too. Heres my experience with cytoxan:

When I first got sick (I was 12 years old). I had lupus nephritis stage 4. I took Cytoxan for two and a half years. I took it once a month at the "child" dose for a while but it wasn't really helping much. This is when they raised my dose to the "adult" dose and I continued doing that for about the last 2 yrs. I pretty much went every month besides maybe the last 6 months I was on cytoxan. The cytoxan helped me get out of being really sick and I felt pretty much normal again but then it seemed that it hit a wall and I wasn't improving as much. This is when I switched to Cellcept.
The cellcept helped alot and it was much more pleasant than the cytoxan.
I was also wondering if your son is on prednisone. He most likely is I'm sure. I have been taking predinose also ever since I was diagnosed to help with the lupus nephritis.
Good Luck and let us know how things go.

10-07-2007, 06:48 PM
Thank you for your responses. I am sorry but for some reason I did not even see them until now. My son's Dr. stopped the Cytoxan after his third tx. His lab results had dramatically improved and he felt nauseous and very weak and shaky after the third tx. He had stage 4 lupus neprhitis so he is currently taking Cellcept and Prednisone and feeling much better. He is being tapered on the Prednisone now and we are praying that he will continue to improve on the Cellcept. So far, so good. Thanks again to you all.
:D Blessings,

10-07-2007, 08:18 PM
I am so happy to hear that you son is feeling much better :lol: Cellcept works for many and it allows for the reduction of Prednisone. I am glad to hear that it is working for your son. Keep us posted and know that we are here for you!

Peace and Blessings

10-19-2007, 05:31 PM
Hi, I just joined this forum. Read your stuff. I am 34 years old,was diagnosed when I was 22. I had lupus nephritis at the onset of my lupus. I may have had lupus prior to but who really knows. I have no clue how long I was on chemo/cytoxin, but when I was done the doctor said my kidney was a s good as new and just as strong as anybodys. When we started out he said I was very close to kidney failure. Anywho, I have had no recurrence of the nephritis since. And I don't plan on having another bout of it either. Rebecca

11-28-2007, 08:19 PM
I recently had a kidney biopsy that shows at least stage 3 nephritis. The doc is recommending cytoxan and 60 mg prednisone. I really don't want to go the cytoxan path and I feel like seeing how the prednisone goes for awhile. Have others found this less intense approach successful? What is cellcept? It has been mentioned a few times in this post. Can it help put the nephritis in remission?

I chose last month to not start the cytoxan and the doc and I agreed to wait a month and see how my naturopathic treatments worked. Due to low and dropping blood levels (anemia) I chose to take the prednisone 7 days ago; a big deal for me. Anyway, I see the doc again tomorrow and we're going to look at the results of a recent 24 hour urine test and discuss options. I would love to have some more insights before deciding what path to take. And have some good questions to take into my appointment.

Can anyone provide insight on this? THANKS! :D