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

Acta Neurol Scand. 1995 Jan;91(1):22-7. doi: 10.1111/j.1600-0404.1995.tb05838.x.


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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Dose-Response Relationship, Drug*
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphatic Irradiation* / adverse effects*
  • Lymphocyte Count / radiation effects
  • Male
  • Middle Aged
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / radiotherapy*
  • Prednisone / administration & dosage*
  • Prednisone / therapeutic use*
  • Treatment Outcome


  • Prednisone