Total Lymphoid Irradiation in Tertiary Care for Rheumatoid Arthritis
Authors: DAVID E. TRENTHAM
Journal: Annals of Internal Medicine (1985)

Editorials1 April 1985Total Lymphoid Irradiation in Tertiary Care for Rheumatoid ArthritisDAVID E. TRENTHAM, M.D., MICHAEL E. WEINBLATT, M.D., K. FRANK AUSTEN, M.D.DAVID E. TRENTHAM, M.D.Search for more papers by this author, MICHAEL E. WEINBLATT, M.D.Search for more papers by this author, K. FRANK AUSTEN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-4-544 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptRecalcitrance of the disease or the emergence of unacceptable drug side effects eventually make some patients with rheumatoid arthritis unsuitable for all medications, including gold or penicillamine, currently approved by the Food and Drug Administration for the management of that disease. In such patients, the physician currently has few options at the tertiary level of care to alleviate morbidity and slow further joint destruction. Ongoing research is directed to evaluating the use of lymphoplasmapheresis (1), leukapheresis (2), methotrexate (3), and fractionated total lymphoid irradiation (4, 5) for refractory patients. A recently completed, multicenter controlled trial (3) and a randomized crossover...References1. WALLACEGOLDFINGERLOWE DDC. A double-blind controlled study of lymphoplasmapheresis versus sham apheresis in rheumatoid arthritis. N Engl J Med. 1982;306:1406-10. CrossrefMedlineGoogle Scholar2. WAHLWILDERKATONA SRI. Leukapheresis in rheumatoid arthritis: association of clinical improvement with reversal of anergy. Arthritis Rheum. 1983;26:1076-84. CrossrefMedlineGoogle Scholar3. WARD J. A prospective randomized controlled trial of low dose pulse methotrexate (MTX) in rheumatoid arthritis (RA). [Abstract]. Arthritis Rheum. 1984;27(suppl):S40. MedlineGoogle Scholar4. KOTZINSTROBERENGLEMAN BSE. Treatment of intractable rheumatoid arthritis with lymphoid irradiation. N Engl J Med. 1981;305:969-76. CrossrefMedlineGoogle Scholar5. TRENTHAMBELLIANDERSON DJR. Clinical and immunologic effects of fractionated total lymphoid irradiation in refractory rheumatoid arthritis. N Engl J Med. 1981;305:976-82. CrossrefMedlineGoogle Scholar6. FIELDSTROBERHOPPE ESR. Sustained improvement of intractable rheumatoid arthritis after total lymphoid irradiation. Arthritis Rheum. 1983;26:937-46. CrossrefMedlineGoogle Scholar7. BRAHNHELFGOTTBELLI ESJ. Total lymphoid irradiation therapy in refractory rheumatoid arthritis: fifteen- to forty-month followup. Arthritis Rheum. 1984;27:481-8. CrossrefMedlineGoogle Scholar8. KAPLAN H. Hodgkin's Disease. 2nd ed. Cambridge, Massachusetts: Harvard University Press; 1980. Google Scholar9. STROBERTANAYFIELD SAE. Efficacy of total lymphoid irradiation in intractable rheumatoid arthritis: a double-blind, randomized trial. Ann Intern Med. 1985;102:441-9. LinkGoogle Scholar10. WILLIAMSWARDREADING HJJ. Low-dose D-penicillamine therapy in rheumatoid arthritis: a controlled, double-blind clinical trial. Arthritis Rheum. 1983;26:581-92. CrossrefMedlineGoogle Scholar11. WARDWILLIAMSEGGER JHM. Comparison of auranofin, gold sodium thiomalate, and placebo in the treatment of rheumatoid arthritis: a controlled clinical trial. Arthritis Rheum. 1983;26:1303-15. CrossrefMedlineGoogle Scholar12. HELLMANMAUCHGOODMANROSENTHALMOLONEY SPRDW. The place of radiation therapy in the treatment of Hodgkin's disease. Cancer. 1978;42 (2 suppl):971-8. CrossrefMedlineGoogle Scholar13. COHENLOERTSCHERRUBINTILNEYCARPENTERSTROM DRMNCT. Cyclosporine: a new immunosuppressive agent for organ transplantation. Ann Intern Med. 1984;101:667-82. LinkGoogle Scholar14. PIN ALSMASILARSEN RAR. Preliminary criteria for clinical remission in rheumatoid arthritis. Arthritis Rheum. 1981;24:1308-15. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Brigham and Women's Hospital Beth Israel Hospital Harvard Medical School Boston, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNanocrystalline ZnO forKnoevenagel Condensation and Reduction of the Carbon,Carbon Double Bond in Conjugated AlkenesTreatment of rheumatoid arthritis with total lymphoid irradiation: Long-term survivalInterferone bei rheumatischen ErkrankungenArthritis in the Elderly: Is it Degenerative or Rheumatoid?Response to total body irradiation in dermatomyositisInvestigational therapy in rheumatoid arthritis: A critical review2,000-Centigray total lymphoid irradiation for refractory rheumatoid arthritisImmunomodulatory treatment in patients with rheumatic diseases: Mechanisms of actionRole of Membranes, Free Radicals, and Copper in Radiation-Induced Changes in Quaternary Structure of DNA: Some Clinical Implications 1 April 1985Volume 102, Issue 4Page: 544-545KeywordsAdverse reactionsFood and Drug AdministrationMethotrexateMorbidityRheumatoid arthritis Issue Published: 1 April 1985 PDF downloadLoading ...