Treatment of intractable rheumatoid arthritis with total lymphoid irradiation

Journal Article · Thu Oct 22 04:00:00 EDT 1981 · N.Engl. J. Med.; (United States)

DOI:https://doi.org/10.1056/NEJM198110223051702· OSTI ID:5345469

Kotzin, B L; Strober, S; Engleman, E G; Calin, A; Hoppe, R T; Kansas, G S; Terrell, C P; Kaplan, H S

Eleven patients with intractable rheumatoid arthritis were treated with total lymphoid irradiation (total dose, 2000 rad) in an uncontrolled feasibility study, as an alternative to long-term therapy with cytotoxic drugs such as cyclophosphamide and azathioprine. During a follow-up period of five to 18 months after total lymphoid irradiation, there was a profound and sustained suppression of the absolute lymphocyte count and in vitro lymphocyte function, as well as an increase in the ratio of Leu-2 (suppressor/cytotoxic) to Leu-3 (helper) T cells in the blood. Persistent circulating suppressor cells of the mixed leukocyte response and of pokeweek mitogen-induced immunoglobulin secretion developed in most patients. In nine of the 11 patients, these changes in immune status were associated with relief of joint tenderness and swelling and with improvement in function scores. Maximum improvement occurred approximately six months after irradiation and continued for the remainder of the observation period. Few severe or chronic side effects were associated with the radiotherapy.

• OSTI ID: 5345469
• Journal Information: N.Engl. J. Med.; (United States), Journal Name: N.Engl. J. Med.; (United States) Vol. 305:17; ISSN NEJMA
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
560151 -- Radiation Effects on Animals-- Man
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANIMAL CELLS
BIOLOGICAL EFFECTS
BIOLOGICAL MATERIALS
BIOLOGICAL RADIATION EFFECTS
BLOOD
BLOOD CELLS
BODY
BODY FLUIDS
BONE JOINTS
CONNECTIVE TISSUE CELLS
DISEASES
DOSES
EXTERNAL IRRADIATION
IRRADIATION
LEUKOCYTES
LYMPHATIC SYSTEM
LYMPHOCYTES
MATERIALS
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIATION DOSES
RADIATION EFFECTS
RADIOLOGY
RADIOTHERAPY
RHEUMATIC DISEASES
SIDE EFFECTS
SKELETAL DISEASES
SKELETON
SOMATIC CELLS
SYMPTOMS
THERAPY
WHOLE-BODY IRRADIATION