Clinical and immunologic effects of fractionated total lymphoid irradiation in refractory rheumatoid arthritis

Journal Article · Thu Oct 01 04:00:00 EDT 1981 · New Engl. J. Med.; (United States)

DOI:https://doi.org/10.1056/NEJM198110223051703· OSTI ID:5920994

Trentham, D E ^[1]; Buckley, J A; Goetzl, E J; David, J R; Austen, K F

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1. Harvard Medical School, Boston, MA

Ten patients with refractory rheumatoid arthritis were given 3000 rad of fractionated total lymphoid irradiation in an uncontrolled therapeutic trial. Total lymphoid irradiation was associated with objective evidence of considerable clinical improvement in eight patients and with reduced blood lymphocyte counts in all 10. On completion of irradiation, there was an abrogation of lymphocyte reactivity in vitro in the patients with clinical responses, but abnormal antibody activities characteristic of rheumatoid arthritis and normal components of humoral immunity were not suppressed. Partial recrudescence of arthritis occurred shortly before a year after the completion of irradiation and was paralleled by a restitution of lymphocyte concentrations and responsiveness to mitogens to levels similar to those observed before irradiation. These data provide further evidence of T-cell involvement in the pathogenesis of rheumatoid arthritis and demonstrate that total lymphoid irradiation can induce temporary relief, but they do not ascertain whether the natural history of this disease was altered.

• OSTI ID: 5920994
• Journal Information: New Engl. J. Med.; (United States), Journal Name: New Engl. J. Med.; (United States) Vol. 305:17; ISSN NEJMA
• Country of Publication: United States
• Language: English

Related Subjects

550600 -- Medicine
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 MATERIALS
BLOOD
BLOOD CELLS
BLOOD PLATELETS
BODY FLUIDS
CONNECTIVE TISSUE CELLS
DATA
DISEASES
EXPERIMENTAL DATA
IMMUNOSUPPRESSION
IMMUNOTHERAPY
INFORMATION
IRRADIATION
LEUKOCYTES
LYMPHOCYTES
MATERIALS
MEDICINE
NUCLEAR MEDICINE
NUMERICAL DATA
PATIENTS
RADIOLOGY
RADIOTHERAPY
RHEUMATIC DISEASES
SIDE EFFECTS
SKELETAL DISEASES
SOMATIC CELLS
THERAPY