Treatment of intractable rheumatoid arthritis with total lymphoid irradiation (TLI): immunological and clinical changes.
Eleven patients with intractable rheumatoid arthritis were treated with total lymphoid irradiation in a feasibility study. The mantle and the inverted Y fields were treated successively to a cumulative dose of 2000 rads. Nine of eleven patients showed at least a 35% improvement in three of four clinical parameters by six months and continued to maintain at least this level of improvement at their last observation points (13-28 months after TLI). There was a marked decrease in the percentage of total T cells and Leu-3 cells (helper), but an increase in the percentage of Leu-2 cells (suppressor/cytotoxic), resulting in a dramatic increase in the Leu-2/Leu-3 ratio. There was also a decrease in response to PHA, Con A and MLR.
D000818:Animals; D000907:Antibodies, Bacterial / Q000032:analysis; D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000532:radiotherapy*; D001323:Autoantibodies / Q000032:analysis; D006801:Humans; D007136:Immunoglobulins / Q000378:metabolism; D008221:Lymphoid Tissue / Q000528:radiation effects*; D008722:Methods; D011241:Prednisone / Q000627:therapeutic use; D011878:Radiotherapy / Q000009:adverse effects; D013601:T-Lymphocytes / Q000145:classification / Q000528:radiation effects; D006377:T-Lymphocytes, Helper-Inducer / Q000528:radiation effects; D050378:T-Lymphocytes, Regulatory / Q000528:radiation effects
D000907:Antibodies, Bacterial; D001323:Autoantibodies; D007136:Immunoglobulins; D011241:Prednisone