It seems reasonably clear that combination chemotherapy may be associated with rheumatic manifestations. On the one hand, this may consist of a relatively self-limiting condition characterized by arthralgia and myalgia with negative autoimmune serology and this has been given the name postchemotherapy rheumatism. On the other hand, there may be a rare subgroup of patients who develop an autoimmune connective tissue disease following combination chemotherapy which may represent another facet of the so-called postchemotherapy rheumatism syndrome. In addition, tamoxifen and certain chemotherapy agents such as bleomycin and particularly interferon-« may be associated with the development of diseases such as Raynaud's syndrome, scleroderma or SLE as well as nonspecific rheumatic symptoms such as myalgia and polyarthritis/polyarthralgia. The interaction between these drugs and the immune system and their effects on the balance of self-tolerance may yield useful insights into the pathology of the idiopathic connective tissue diseases.

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