We successfully treated a patient with chronic lymphocytic leukemia (CLL) 
associated with a nephrotic syndrome. An 82-year-old man had been diagnosed as 
having CLL and been under observation for a year without treatment. In January, 
2001, he developed hypoprotenemia, proteinurea, and edema in the extremities and 
face. With the exacerbation of the symptoms, he was admitted to our hospital in 
March of the same year. Under the diagnosis of nephrotic syndrome with CLL, the 
patient underwent induction therapy for CLL with fludarabine (13 mg/m2/day for 4 
days), which brought about a complete remission of CLL and the disappearance of 
the edema. To our knowledge, this was the first case in Japan where fludarabine 
was dramatically effective in treating both CLL and the nephrotic syndrome. This 
result indicated that fludarabine is beneficial for not only CLL but also 
complications like nephrotic syndrome.