The influence of a partially HLA-matched blood transfusion on the disease activity of rheumatoid arthritis.
OBJECTIVE
Based on the immunosuppressive effects of blood transfusions in organ transplantation, we determined the effect of a blood transfusion on disease activity of rheumatoid arthritis (RA).


METHODS
In this double-blind pilot study, 40 patients with active RA were randomly assigned to receive a HLA-DRB1-matched blood transfusion (n = 30) or placebo (n = 10). Disease activity was scored according to the American College of Rheumatology response criteria during 6 months of follow-up.


RESULTS
After 1 month and 6 months, respectively, 6 and 16% of patients fulfilled the response criteria in the blood transfusion group compared to none and 30%, respectively, in the placebo group. Following correction for the increase in haemoglobin levels, a majority of the response parameters in the blood transfusion group showed significant improvement compared to the placebo group.


CONCLUSIONS
A DRB1-matched blood transfusion shows improvement of symptoms in several RA patients. Additional studies are required to identify blood transfusion regimens that enhance the potential for therapeutic responses.
van der Horst-Bruinsma
I E
IE
Department of Rheumatology, Leiden University Medical Centre, The Netherlands.
Huizinga
T W
TW
Lagaay
E M
EM
Hazes
J M
JM
Breedveld
F C
FC
Schreuder
G M
GM
Tomson
T A
TA
Zwinderman
A H
AH
van Rood
J J
JJ
de Vries
R R
RR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000503:physiopathology* / Q000628:therapy; D001788:Blood Grouping and Crossmatching; D001799:Blood Sedimentation; D001803:Blood Transfusion; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006684:HLA-DR Antigens / Q000097:blood*; D059811:HLA-DRB1 Chains; D006801:Humans; D007596:Joints / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D010865:Pilot Projects; D016133:Polymerase Chain Reaction; D012217:Rheumatoid Factor / Q000097:blood; D012720:Severity of Illness Index; D016896:Treatment Outcome
D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; D012217:Rheumatoid Factor