RT Journal Article
SR Electronic
T1 Blood leukocyte levels as potential prognostic markers in IPF
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA388
DO 10.1183/13993003.congress-2021.PA388
VO 58
IS suppl 65
A1 Andrew Achaiah
A1 Andrea Pereira
A1 Harriet Bothwell
A1 Kritica Dwivedi
A1 Armila Rathnapala
A1 Rosia Barker
A1 Valentina Iotchkova
A1 Rachel Hoyles
A1 Ling-Pei Ho
YR 2021
UL http://erj.ersjournals.com/content/58/suppl_65/PA388.abstract
AB Background: The prognosis of IPF is poor and there is a need for clinically accessible prognostic biomarkers.Objective: To explore association between blood leukocytes (monocytes, neutrophils and lymphocytes) and prognosis in patients with IPF.Method: We performed a retrospective analysis of an IPF cohort (n=182) first seen in the Oxford ILD Service between 2013-2017. Correlation between full blood count within 4 months of first clinic and lung function decline, hospitalisation and survival was assessed using Cox Proportional Hazard regression analysis.Results: 128 patients had contemporaneous full blood count measurement within 4 months of first clinic assessment. Mean (±SD) length of follow up was 2.9 ±1.4y, age 75.2 ±7.8y, 78% male. Maximal time to censoring was 7.1 years. 25 (19.5%) cases had a hospitalisation event, 50 (43.9%) showed FVC decline >10%/y and death occurred in 56 (43.8%) cases. In multivariate models (adjusted for age, gender, initial FVC%) neutrophils were associated with FVC decline [HR 1.36, 95% CI 1.11-1.68, p=0.004] and all-cause mortality [1.24, 1.08-1.42, p=0.002]. Monocyte levels were associated with mortality only [1.36, 1.04-1.77, p=0.024]. In univariate modelling neutrophils were associated with hospitalisation [1.15, 1.0-1.32, p=0.049]. Dichotomised blood leukocytes levels (by mean) identified neutrophils >5.5x103/µl as a correlate of all-cause mortality [2.3, 1.34-3.9, p=0.002]; median survival 36.2 vs 55 months.Conclusion: In this IPF cohort, raised neutrophil and monocyte levels are associated with greater lung function decline and increased risk of mortality over a 3 year period. Blood monocyte and neutrophil levels at time of initial assessment may serve as a prognostic biomarker.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA388.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).