Total lymphoid irradiation therapy in refractory rheumatoid arthritis. Fifteen- to forty-month followup

Journal Article · Tue May 01 00:00:00 EDT 1984 · Arthritis Rheum.; (United States)

DOI:https://doi.org/10.1002/art.1780270501· OSTI ID:6743066

Brahn, E; Helfgott, S M; Belli, J A; Anderson, R J; Reinherz, E L; Schlossman, S F; Austen, K F; Trentham, D E

Twelve patients with refractory rheumatoid arthritis were treated with total lymphoid irradiation (TLI) to a total cumulative dose of 3,000 rads. Post-TLI morbidity/mortality included 8 patients with xerostomia, 4 with weight loss of greater than 10 kg, 3 with loss of 4 or more teeth, 3 with herpes zoster, 4 with bacterial infection that was fatal in 2, 3 with hypothyroidism, 1 with cutaneous vasculitis, and death from myocardial infarction in 1 patient and cardiorespiratory arrest in another. Ten of the patients were reevaluated 15-40 months (mean +/- SE, 30 +/- 2) after completion of TLI, and significant improvement was noted in several disease parameters including number of swollen joints, duration of morning stiffness, and 50-foot walking time. Blood lymphopenia and a decrease in helper T cells (T4) were also noted. These data suggest that changes in immunoregulation induced by TLI can produce longlasting alterations in rheumatoid arthritis, although adverse effects may limit its efficacy.

• Research Organization: Department of Medicine, Harvard Medical School, Boston, Massachusetts
• OSTI ID: 6743066
• Journal Information: Arthritis Rheum.; (United States), Vol. 27:5
• Country of Publication: United States
• Language: English

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