Respiratory Research (May 2021)

Increased monocyte count and red cell distribution width as prognostic biomarkers in patients with Idiopathic Pulmonary Fibrosis

  • Theodoros Karampitsakos,
  • Sebastiano Torrisi,
  • Katerina Antoniou,
  • Effrosyni Manali,
  • Ioanna Korbila,
  • Ourania Papaioannou,
  • Fotios Sampsonas,
  • Matthaios Katsaras,
  • Eirini Vasarmidi,
  • Despoina Papakosta,
  • Kalliopi Domvri,
  • Eva Fouka,
  • Ioannis Organtzis,
  • Zoe Daniil,
  • Ilias Dimeas,
  • Paraskevi Kirgou,
  • Konstantinos I. Gourgoulianis,
  • Ilias C. Papanikolaou,
  • Katerina Markopoulou,
  • Georgia Kounti,
  • Eirini Tsapakidou,
  • Efthymia Papadopoulou,
  • Konstantinos Tatsis,
  • Athena Gogali,
  • Konstantinos Kostikas,
  • Vasilios Tzilas,
  • Serafeim Chrysikos,
  • Spyridon Papiris,
  • Demosthenes Bouros,
  • Michael Kreuter,
  • Argyrios Tzouvelekis

DOI
https://doi.org/10.1186/s12931-021-01725-9
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 10

Abstract

Read online

Abstract Background Idiopathic Pulmonary Fibrosis (IPF) represents a chronic lung disease with unpredictable course. Methods We aimed to investigate prognostic performance of complete blood count parameters in IPF. Treatment-naïve patients with IPF were retrospectively enrolled from two independent cohorts (derivation and validation) and split into subgroups (high and low) based on median baseline monocyte count and red cell distribution width (RDW). Results Overall, 489 patients (derivation cohort: 300, validation cohort: 189) were analyzed. In the derivation cohort, patients with monocyte count ≥ 0.60 K/μL had significantly lower median FVC%pred [75.0, (95% CI 71.3–76.7) vs. 80.9, (95% CI 77.5–83.1), (P = 0.01)] and DLCO%pred [47.5, (95% CI 44.3–52.3) vs. 53.0, (95% CI 48.0–56.7), (P = 0.02)] than patients with monocyte count < 0.60 K/μL. Patients with RDW ≥ 14.1% had significantly lower median FVC%pred [75.5, (95% CI 71.2–79.2) vs. 78.3, (95% CI 76.0–81.0), (P = 0.04)] and DLCO%pred [45.4, (95% CI 43.3–50.5) vs. 53.0, (95% CI 50.8–56.8), (P = 0.008)] than patients with RDW < 14.1%. Cut-off thresholds from the derivation cohort were applied to the validation cohort with similar discriminatory value, as indicated by significant differences in median DLCO%pred between patients with high vs. low monocyte count [37.8, (95% CI 35.5–41.1) vs. 45.5, (95% CI 41.9–49.4), (P < 0.001)] and RDW [37.9, (95% CI 33.4–40.7) vs. 44.4, (95% CI 41.5–48.9), (P < 0.001)]. Patients with high monocyte count and RDW of the validation cohort exhibited a trend towards lower median FVC%pred (P = 0.09) and significantly lower median FVC%pred (P = 0.001), respectively. Kaplan–Meier analysis in the derivation cohort demonstrated higher all-cause mortality in patients with high (≥ 0.60 K/μL) vs. low monocyte count (< 0.60 K/μL) [HR 2.05, (95% CI 1.19–3.53), (P = 0.01)]. Conclusions Increased monocyte count and RDW may represent negative prognostic biomarkers in patients with IPF.

Keywords