HEMATOLOGIC AND CYTOFLUOROGRAPHIC ANALYSIS OF PATIENTS WITH FELTYS-SYNDROME - A HYPOTHESIS THAT A DISCRETE-EVENT LEADS TO LARGE GRANULAR LYMPHOCYTE EXPANSIONS IN THIS CONDITION

Objective, To compare hematologic and cytofluorographic features in Fe lty's syndrome (FS) patients with and without the large granular lymph ocyte (LGL) syndrome. Methods. Peripheral blood cells from FS patients and from 2 control groups (rheumatoid arthritis [RA] patients and sub jects without symptoms of a rheumatic disease) were analyzed by hemato logic and cytofluorographic techniques, A separate assessment of disea se activity was performed. Results. FS patients had reduced lymphocyte and platelet counts, with a parallel reduction in lymphocyte subsets examined. CD4 counts were reduced in all FS patients, including those with the LGL syndrome. Disease activity was lower in FS patients than in RA control patients. Treatment was similar in all patient groups, N o direct association was seen between LGL numbers and duration of RA o r neutrophil counts in RA groups. Conclusion. Hematologic abnormalitie s in FS extend beyond neutropenia, Although similarities were seen bet ween FS patients and FS patients with the LGL syndrome (e.g,, CD4 lymp hopenia), evidence for a gradation from FS to the LGL syndrome was not seen, thus favoring the hypothesis that a ''transforming event'' is r equired.