INCIDENCE OF CANCER AMONG MEN WITH THE FELTY SYNDROME

Objective: To estimate the incidence of cancer (especially lymphoproli ferative malignancies) in patients with the Felty syndrome. Design: A retrospective cohort study. Setting: A computerized database of all di scharge records for 1969 to 1990 from a Veterans Affairs hospital. Pat ients: 906 men with a discharge diagnosis of the Felty syndrome. Measu rements: Standardized incidence ratios (SIR) (ratios of observed-to-ex pected events) estimated the risk for specific cancers. Hospital recor ds confirmed the diagnoses of the Felty syndrome and cancer. Results: We observed a twofold increase in total cancer incidence (137 patients ; SIR = 2.09; 95% CI, 1.8 to 2.5). The risk for non-Hodgkin lymphoma ( 19 patients; SIR = 12.8, CI, 7.7 to 20.0) was much greater than the tw ofold increase in risk for lymphoma generally reported for rheumatoid arthritis. The risk for leukemia was increased but only within 5 years of the first hospitalization for the Felty syndrome, (13 patients; SI R = 7.67; CI, 4.1 to 13.1). Conclusion: The increased risk for non-Hod gkin lymphoma after the Felty syndrome in our study is similar to the risk associated with the Sjogren syndrome and may reflect similar immu nostimulatory mechanisms.