Arthropathies Associated With Cancer Immunotherapy

The immunotherapy of malignancy utilises the hosts immune system to destroy neoplastic cells. Polyarthritis may evolve or reappear as a result of this therapy. In a report of 3 patients receiving IL-2 immunotherapy for metastatic melanoma and renal-cell carcinoma, 2 patients developed a clinical picture resembling rheumatoid arthritis. A third patient, who had a remote history of Reiters syndrome, developed symmetric oligoarthritis [67]. The authors postulated induction of an autoimmune arthritis via an IL-2 induced T-cell mechanism, based on the inflammatory histologic findings, elevated levels of rheumatoid factor, positive antinuclear antibodies and positive HLA-DR4 genotype. Patients receiving IL-2 also developed spondiloarthritis with peripheral involvement and psoriatic arthritis [68]. The arthritis was self-limited, with improvement when immunotherapy was stopped but could be reproducibly induced by successive treatment cycles. HLA typing of these patients showed the presence of HLA-B27 and HLA-B38, both major histocompatibility complex antigens associated with the respective diseases. Three cases of self-limited symmetrical polyarthritis following tamoxifen therapy for breast cancer were described [69]. Arthritis was also seen in patients after interferon-a treatment. Pol yarthritis was the most common type of presentation, reported in 19 patients. Oligoarthritis or monoarthritis were less common, described in only 5 patients [70], Lately, there have been several reports on the development of symmetric polyarthritis in patients receiving Calmette-Guerin bacillus immunotherapy [71-73].

Patients with cancer undergoing immunotherapy may provide an excellent model for investigation and clarifying the mechanisms underlying inflammatory arthritides and autoimmunity in general [67],

Arthritis Relief Now

Arthritis Relief Now

When you hear the word arthritis, images of painful hands and joints comes into play. Few people fully understand arthritis and this guide is dedicated to anyone suffering with this chronic condition and wants relief now.

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