Clonal T cell populations are frequently detected in patients with rheumatic diseases. The relevance of this finding is often uncertain, as the clinical spectrum can range from being asymptomatic to T cell leukemia. Former studies suggested that certain anti-rheumatic drugs might influence the course of the clonal T cell populations. A prospective long-term follow up study was performed including patients with rheumatic diseases and clonal T cell populations. Clinical features, adverse events, especially infections and cytopenias, and immunosuppressive medication were assessed. T cell populations were characterized by polymerase chain reaction, flow cytometry and stimulated cell cultures. 28 Patients with rheumatoid arthritis, spondyloarthritis, or giant cell arteritis were prospectively followed for up to 7.6 years. Severe infections or cytopenias (10.7% autoimmune neutropenias) were rare. The clonal T cell populations mostly persisted over time, the tumor burden decreased in the long-term. The cytokine secretion in stimulated T cell cultures did not differ in the subgroup of RA patients with versus without clonal T cells. Clonal T cell populations in patients with rheumatic diseases are common, but are rarely harmful. Feared neutropenia, infections or progression into T cell leukemia could not be detected in the long-term in our cohort.

中文翻译：

---

克隆性 T 细胞群几乎不会损害风湿性疾病患者：一项前瞻性长期随访研究


克隆性 T 细胞群经常在风湿性疾病患者中检测到。这一发现的相关性通常不确定，因为临床范围从无症状到 T 细胞白血病。以前的研究表明，某些抗风湿药可能会影响克隆性 T 细胞群的病程。进行了一项前瞻性长期随访研究，包括风湿性疾病患者和克隆性 T 细胞群。评估临床特征、不良事件，尤其是感染和血细胞减少以及免疫抑制药物。通过聚合酶链反应、流式细胞术和刺激细胞培养对 T 细胞群进行表征。28 例类风湿性关节炎、脊柱关节炎或巨细胞动脉炎患者接受了长达 7.6 年的前瞻性随访。严重感染或血细胞减少 （10.7% 自身免疫性中性粒细胞减少症） 很少见。克隆性 T 细胞群大多随着时间的推移而持续存在，肿瘤负荷长期下降。受刺激的 T 细胞培养物中细胞因子分泌在有克隆性 T 细胞和无克隆性 T 细胞的 RA 患者亚组中没有差异。风湿性疾病患者的克隆性 T 细胞群很常见，但很少有害。在我们的队列中，无法长期检测到令人担忧的中性粒细胞减少症、感染或进展为 T 细胞白血病。