Total lymphoid irradiation in rheumatoid arthritis. A ten-year followup.
OBJECTIVE
To report the findings of a 10-year followup of patients enrolled in a randomized trial of total lymphoid irradiation (TLI) versus chemotherapy for rheumatoid arthritis (RA).


METHODS
A retrospective analysis of the charts of 19 patients who had been included in a randomized trial comparing TLI and chemotherapy for the treatment of RA.


RESULTS
Ten years after the start of the trial, a higher number of TLI-treated patients had died (7 of 10), compared with patients who had received chemotherapy (2 of 9). In addition, 3 of the TLI-treated patients developed B cell-related malignancies, whereas no such malignancies developed in the control group.


CONCLUSIONS
TLI was associated with a less-favorable long-term outcome than chemotherapy. These data stress the importance of careful long-term followup in experimental trials of immunosuppressive agents.
Westhovens
R
R
University Hospitals, Katholieke Universiteit Leuven, Belgium.
Verwilghen
J
J
Dequeker
J
J
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000532:radiotherapy*; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D008221:Lymphoid Tissue / Q000528:radiation effects*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D013997:Time Factors; D014916:Whole-Body Irradiation / Q000401:mortality