High-dose cyclophosphamide chemotherapy for refractory rheumatoid arthritis

Objective To study the feasibility,efficacy,and safety of high dose cyclophosphamide (HDC) chemotherapy for refractory rheumatoid arthritis (RA).Method Four patients with refractory RA received the treatment of HDC.Cyclophosphamide was chosen for high dose chemotherapy with 80～100 mg/kg within 2 or 3 days,total dosage was 4 or 5 g.The features of clinical manifestation and lab findings before and after the treatment were compared.The literatures associated with HDC were reviewed.Results All of four patients achieved complete remission and remained in continuous complete remission for 6 to 12 months of follow up.The lab findings associated with disease activity were nearly normal.HDC was well tolerated and there were no severe side effects.Conclusion HDC chemotherapy is feasible and safe in these four refractory RA patients,it induced complete remission in them.But it is very important to select refractory RA patients,and it need more patients and longer follow up period to know if HDC.