Lack of effect of total body irradiation in rheumatoid arthritis

We are reporting a pilot study of total body irradiation in six patients with progressive rheumatoid arthritis, who had previously received gold and penicillamine. Radiation (150 cGy) was administered in ten fractions over 5 weeks. There was a transient pancytopenia following radiotherapy and the total peripheral lymphocyte count remained below pre-treatment levels after 6 months. There were no serious short-term adverse effects. By 6 months, there was no evidence of any change in clinical and laboratory estimates of disease activity. We feel that further studies of this regimen in intractable rheumatoid arthritis are not justified.