Fractionated Total Lymphoid Irradiation: A Promising New Treatment for Rheumatoid Arthritis? Yes, No, Maybe

Zvaifler, Nathan J.

doi:10.1002/art.1780300117

Cited by 18 publications

(5 citation statements)

References 17 publications

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“…The initial studies were uncontrolled and showed clinical improvement in most subjects. Efficacy was also reported in several other institutions (15). Frequent short-term toxic events have included herpes zoster and bacterial infections, reversible bone marrow suppression, and persistent lymphopenia.…”

Section: Discussionmentioning

confidence: 79%

“…Our present study addresses the question of safety and long-term outcomes in TLI-treated patients compared with conventionally treated controls. Several centers have conducted trials on TLI for RA, and the largest number of patients followed up has been at our institution (15). The initial studies were uncontrolled and showed clinical improvement in most subjects.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of rheumatoid arthritis with total lymphoid irradiation: Long-term survival

Uhrin

Wang

Matsuda

et al. 2001

Arthritis & Rheumatism

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Treatment of rheumatoid arthritis with total lymphoid irradiation: Long-term survival

Uhrin

Wang

Matsuda

et al. 2001

Arthritis & Rheumatism

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“…However, the irradiation should be carefully designed, given its other associated biological effects, including secondary malignancies. Total lymphoid irradiation of patients with refractory RA resulted in severe toxicities 43 . Adenovirusmediated gene transfer specifically targeted non-lymphoid cells, and allowed us to demonstrate that p16 INK4a induction in synovial tissue can suppress the main pathology of the arthritis.…”

Section: Discussionmentioning

confidence: 99%

Induction of the p16INK4a senescence gene as a new therapeutic strategy for the treatment of rheumatoid arthritis

Taniguchi

Kohsaka

Inoue

et al. 1999

Nat Med

157

103

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Synovial tissue affected by rheumatoid arthritis is characterized by proliferation, which leads to irreversible cartilage and bone destruction. Current and experimental treatments have been aimed mainly at correcting the underlying immune abnormalities, but these treatments often prove ineffective in preventing the invasive destruction. We studied the expression of cyclin-dependent kinase inhibitors in rheumatoid synovial cells as a means of suppressing synovial cell proliferation. Synovial cells derived from hypertrophic synovial tissue readily expressed p16INK4a when they were growth-inhibited. This was not seen in other fibroblasts, including those derived from normal and osteoarthritis-affected synovial tissues. In vivo adenoviral gene therapy with the p16INK4a gene efficiently inhibited the pathology in an animal model of rheumatoid arthritis. Thus, the induction of p16INK4a may provide a new approach to the effective treatment of rheumatoid arthritis.

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“…This contrasts to the excessive mortality seen following TLI in rheumatoid arthritis, and is similar to the low mortality seen following TLI in Hodgkin's disease patients (13,14). Side effects, including nausea, vomiting, fatigue, alopecia (neck, axilla, chest), and diarrhea have occurred, but not been severe disabling.…”

Section: Discussionmentioning

confidence: 63%

Combination total lymphoid irradiation and low-dose corticosteroid therapy for progressive multiple sclerosis

Cook

Devereux²,

Troiano³

et al. 1995

Acta Neurologica Scandinavica

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PC. Combination total lymphoid irradiation and low-dose corticosteroid therapy for progressive multiple sclerosis. Acta Neurol Scand 1995: 91: 22-27. 0 Munksgaard 1995 Total lymphoid irradiation (TLI) has been reported to delay deterioration in patients with progressive multiple sclerosis and other autoimmune disorders. Methods -In an open trial, the effect of TLI combined with a one year course of low dose prednisone was compared to the effect of sham TLI and TLI only in a prior double-blind study of patients with progressive multiple sclerosis. Results -Twenty-seven patients receiving TLI combined with corticosteroids had significantly greater lymphocytopenia in the year post-therapy than those receiving TLI only or sham TLI and Kaplan Meier product-limit survival analysis showed significantly less progression in the TLI plus steroid group over 4 years of follow-up. No difference in lymphocytopenia or progression was found with TLI plus corticosteroid therapy when the spleen was removed from the field of irradiation. Conclusion -These results lend further support to the hypothesis that TLI may be effective in progressive MS, and indicates that adding low-dose prednisone may enhance this effect. The study also suggests that TLI may be equally effective whether or not the spleen is irradiated.

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Fractionated Total Lymphoid Irradiation: A Promising New Treatment for Rheumatoid Arthritis? Yes, No, Maybe

Cited by 18 publications

References 17 publications

Treatment of rheumatoid arthritis with total lymphoid irradiation: Long-term survival

Treatment of rheumatoid arthritis with total lymphoid irradiation: Long-term survival

Induction of the p16INK4a senescence gene as a new therapeutic strategy for the treatment of rheumatoid arthritis

Combination total lymphoid irradiation and low-dose corticosteroid therapy for progressive multiple sclerosis

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