Bronchoalveolar lavage cell percentages as diagnostic markers of immune checkpoint inhibitor pneumonitis

作者：Mahnoor Mir, Felipe Soto, Pedro Antonio Amezcua Gomez, Rodrigo Del Rio Arroyo, Adarsh Suresh, Amber Su, Qiong Gan, John Stewart, Roberto Adachi, Diwakar D. Balachandran, Lara Bashoura, Roberto F. Casal, Burton F. Dickey, George A. Eapen, Scott E. Evans, Horiana B. Grosu, Carlos A. Jimenez, Julie Qiaojin Lin, David E. Ost, Bruce F. Sabath, Vickie R. Shannon, Aung Naing, Jianjun Gao, Jia Wu, Karthik Suresh, Saadia A. Faiz, Mehmet Altan, Ajay Sheshadri · 发表于：Frontiers in Medicine · 年份：2025 · DOI：10.3389/fmed.2025.1582714 · 被引用次数：5 · 研究领域：Cancer Immunotherapy and Biomarkers、Inflammatory Biomarkers in Disease Prognosis、Lung Cancer Research Studies

Introduction Diagnostic biomarkers for immune checkpoint inhibitor pneumonitis (ICIP) are lacking. Bronchoalveolar lavage (BAL) lymphocytosis has been associated with ICIP, but studies have not evaluated BAL lymphocytosis as a diagnostic biomarker for ICIP. Purpose This study aimed to measure the association of BAL immune cell percentage with ICIP and test its performance as a diagnostic biomarker. Methods We performed a retrospective chart review of 476 patients treated with ICIs for solid organ or hematologic malignancies who underwent BAL between 2016 and 2022. Two independent reviewers, blinded to the results of BAL cell percentage, confirmed the diagnosis of ICIP or other conditions (e.g., pneumonia) based on clinical history and radiology. We constructed logistic regression models to assess the relationship between BAL lymphocyte, eosinophil, and neutrophil percentages and the diagnosis of pneumonitis, and the area under the receiver-operator curves (AUROC) was used to assess their discriminatory function. We measured the association of BAL immune cell percentages with 1-year overall survival using Cox proportional hazard models adjusted for age and cancer diagnosis. Results Each 1% increase in lymphocyte (OR 1.01, 95% CI 1.01–1.02, p < 0.001) and eosinophil percentage (OR 1.05, 95% CI 1.01–1.11, p = 0.01) were independently associated with pneumonitis, while neutrophil percentage was inversely associated (OR 0.99, 95% CI 0.98–0.99, p = 0.01) with pneumonitis. In...