SynthesisBMJ open respiratory research2026
BAL lymphocytosis as a predictive marker for drug response and long-term outcome in fibrotic ILD: systematic review.
Synthesis in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFibrotic interstitial lung diseases (fILDs) encompass a heterogeneous group of disorders characterised by varying degrees of inflammation and/or fibrosis. The role of bronchoalveolar lavage lymphocytosis (BALL) as a prognostic biomarker and predictor of corticosteroid (CS) response remains uncertain. We investigated whether, in patients with fILD, increased BALL can serve as a marker for CS responsiveness and whether increased BALL may also predict better long-term outcomes following CS therapy compared with patients with lower BALL levels.
methodsA systematic review was conducted. MEDLINE, Embase, Web of Science and Google Scholar were searched up to 4 August 2025. Eligible studies included mainly observational clinical studies evaluating BALL in fILD, with a focus on short-term CS response (<6 months) as well as long-term survival (>6 months) after treatment, including changes in lung function parameters, radiological response and overall and progression-free survival. Study selection, data extraction and quality assessment were performed independently by two reviewers. Disagreements were resolved by consensus.
results30 studies involving a total of 3083 patients were included. Increased BALL was associated with better CS response as reflected by improved lung function and increased survival in fILD subtypes, such as hypersensitivity pneumonitis and non-specific interstitial pneumonia. However, BALL thresholds varied, and study heterogeneity precluded meta-analysis. Most studies showed moderate to high risk of bias.
conclusionsIncreased BALL may predict CS responsiveness and treatment outcome prediction in fILD; however, clinical implementation remains limited due to insufficient evidence, predominantly observational studies, inconsistent BALL thresholds and heterogeneous results across disease entities. Standardisation and prospective validations are needed to better integrate BALL findings into clinical routine. PROSPERO REGISTRATION NUMBER: CRD420251057631.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.