What other alkylating agent has been used to treat rheumatic diseases?
Chlorambucil (Leukeran) has been used to treat several rheumatic diseases. The usual dose is 0.1 mg/kg per day (2–8 mg/day). It has been used primarily to treat the ocular and neuropsychiatric complications of Behçet’s disease. It has also been used in cryoglobulinemia, refractory dermatomyositis, lupus nephritis, and amyloidosis secondary to chronic inflammatory arthritis (RA, juvenile idiopathic arthritis, ankylosing spondylitis). Major toxicities are myelosuppression, infection (herpes zoster), and induction of myeloid leukemia and other malignancies.