Snaith M L, Holt J M, Oliver D O, Dunnill M S, Halley W, Stephenson A C
Br Med J. 1973 Apr 28;2(5860):197-201. doi: 10.1136/bmj.2.5860.197.
Six female patients with systemic lupus erythematosus (S.L.E.) have been treated with chlorambucil. In five the decision was taken after failure by corticosteroids to control progressive renal disease in the face of unacceptable corticosteroid toxicity. After the introduction of chlorambucil renal function improved and all patients remain well six, six, five, three, and two-and-a-half years later, respectively. On renal biopsy five had focal proliferative glomerulonephritis. Repeat biopsy in two cases showed quantitative improvement. The sixth patient was treated with chlorambucil because of failure by corticosteroids to control peripheral vascular lesions and haemolysis and she remains well four years later. In four patients is it probable that amenorrhoea was related to chlorambucil treatment, but there were no other important side effects although one patient developed a degree of marrow depression during treatment. Chlorambucil may hold advantages over the immunosuppressive drugs normally recommended in this condition, azathioprine and cyclophosphamide, as it appears less liable to cause important marrow suppression and, unlike cyclophosphamide is not associated with alopecia and haemorrhagic cystitis.
六名系统性红斑狼疮（S.L.E.）女性患者接受了苯丁酸氮芥治疗。其中五名患者是在面对无法接受的皮质类固醇毒性，而皮质类固醇未能控制进行性肾病的情况下决定使用苯丁酸氮芥的。在引入苯丁酸氮芥后，肾功能得到改善，所有患者在分别经过六年、六年、五年、三年和两年半后情况仍然良好。肾活检显示五名患者患有局灶增生性肾小球肾炎。两名患者的重复活检显示有定量改善。第六名患者因皮质类固醇未能控制周围血管病变和溶血而接受苯丁酸氮芥治疗，四年后情况仍然良好。四名患者的闭经可能与苯丁酸氮芥治疗有关，但没有其他重要的副作用，尽管有一名患者在治疗期间出现了一定程度的骨髓抑制。与通常推荐用于这种情况的免疫抑制药物硫唑嘌呤和环磷酰胺相比，苯丁酸氮芥可能具有优势，因为它似乎不太容易引起重要的骨髓抑制，并且与环磷酰胺不同，它不会导致脱发和出血性膀胱炎。
