为了检查老年人强直性脊椎炎（AS）患者患血液恶性肿瘤的风险，我们使用了1999年1月1日至2010年12月31日的美国医保数据，用来识别拥有AS的基于人群的受益者队列。我们还包括了患有炎症性肠病（IBD）的受益者作为疾病对照组，没有AS或IBD的受益者作为未受影响的对照组。我们在此期间排除接受肿瘤坏死因子抑制剂治疗的人群。我们对每个组进行了随访，直到2015年9月30日，在这期间诊断出新的血液恶性肿瘤的索赔。我们包括了12,451名AS受益者，234,905名IBD受益者和10,975,340名未受影响的对照组，平均随访时间分别为9.9年、9.3年和8.0年。我们在AS组中识别出297种血液恶性肿瘤，在IBD组中识别出4538种恶性肿瘤，在未受影响的对照组中识别出128,239种恶性肿瘤。AS组与未受影响的对照组的标准化发病率比为1.39（95％CI，1.05至1.61）非何杰金淋巴瘤，1.50（95％CI，1.17至1.92）慢性淋巴细胞白血病，和1.52（95％CI，1.12至2.06）多发性骨髓瘤。AS中急性髓系白血病和慢性髓系白血病的风险没有升高，霍奇金淋巴瘤的病例太少无法计算风险。风险与IBD受益者相当。我们还进行了有关AS血液恶性肿瘤的风险的系统文献综述，重点关注年龄相关性，这以前还没有研究过。我们在文献综述中发现了21项研究，主要包括年轻或中年患者。结果表明，AS与血液恶性肿瘤的风险增加没有明显关联。两项队列研究报告AS多发性骨髓瘤的风险增加。老年AS患者的非何杰金淋巴瘤、慢性淋巴细胞白血病和多发性骨髓瘤的风险增加。出版者Elsevier Inc.

To examine the risk of hematologic malignancies in older adults with ankylosing spondylitis (AS).We used US Medicare data from January 1, 1999, to December 31, 2010, to identify a population-based cohort of beneficiaries with AS. We also included beneficiaries with inflammatory bowel disease (IBD) as disease controls and beneficiaries without AS or IBD as unaffected controls. We excluded those treated with tumor necrosis factor inhibitors in this period. We followed up each group for new diagnosis claims for hematologic malignancies until September 30, 2015.We included 12,451 beneficiaries with AS, 234,905 with IBD, and 10,975,340 unaffected controls, with a mean follow-up of 9.9, 9.3, and 8.0 years, respectively. We identified 297 hematologic malignancies in the AS group, 4538 malignancies in the IBD group, and 128,239 malignancies in unaffected controls. The standardized incidence ratio in AS vs unaffected controls was 1.39 (95% CI, 1.05 to 1.61) for non-Hodgkin lymphoma, 1.50 (95% CI, 1.17 to 1.92) for chronic lymphocytic leukemia, and 1.52 (95% CI, 1.12 to 2.06) for multiple myeloma. Risks of acute myeloid leukemia and chronic myeloid leukemia were not elevated in AS, and there were too few cases of Hodgkin lymphoma to compute risks. Risks were comparable to those of beneficiaries with IBD. We also performed a systematic literature review of the risk of hematologic malignancy in AS, focusing on age associations, which have not been previously examined. We identified 21 studies in the systematic literature review, which included mainly young or middle-aged patients. Results suggested that AS was largely not associated with an increased risk of hematologic malignancies. Two cohort studies reported an increased risk of multiple myeloma in AS.The risks of non-Hodgkin lymphoma, chronic lymphocytic leukemia, and multiple myeloma are increased among elderly patients with AS.Published by Elsevier Inc.