{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:10:40Z","timestamp":1790143840246,"version":"4.0.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Distinguishing lower respiratory tract infections (LRTIs) from noninfectious pulmonary infiltrates (NPIs) in patients with lymphoma is challenging. We assessed the diagnostic value of bronchoalveolar lavage fluid (BALF) cytokine and lymphocyte profiles (CPs and LPs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 147 participants: 55 lymphoma patients with LRTIs, 52 with NPIs, and 40 non-lymphoma patients with LRTIs. Fourteen BALF cytokines and ten BALF and peripheral blood lymphocyte measures were assessed by multiparameter flow cytometry. LASSO-selected logistic regression models were developed using five-fold cross-validation. BALF models incorporated CPs and LPs, whereas Base models used routine inflammatory markers, with or without sputum production. Models were compared using DeLong tests, NRI, IDI, and 1,000-resample bootstrap optimism correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>LASSO retained BALF IL-8 and CD3\u2009+\u2009CD4\u2009+\u2009for BALF models and CRP and SAA for Base models. Test-set AUCs were 0.845 and 0.853 for BALF-A and BALF-B, vs. 0.973 and 0.969 for Base-A and Base-B, respectively. Base models significantly outperformed corresponding BALF models. Optimism-corrected AUCs were 0.872 for both BALF models and 0.980 and 0.977 for Base-A and Base-B. Adding sputum production improved BALF-model reclassification without significantly increasing AUC and provided no benefit to Base models. Eight immune parameters differed by lymphoma status among patients with LRTIs, with additional infection-type-specific patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BALF IL-8\/CD4-based models distinguished LRTIs from NPIs in patients with lymphoma, although CRP\/SAA-based models performed better. BALF immune profiling may complement conventional biomarkers and reveal immune signatures associated with lymphoma status and infection type.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1904717","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:49:30Z","timestamp":1790142570000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic value of bronchoalveolar lavage fluid cytokine and lymphocyte profiles for lower respiratory tract infections in patients with lymphoma"],"prefix":"10.3389","volume":"13","author":[{"given":"Tianqi","family":"Qi","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenming","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinling","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology Laboratory, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Hematology Laboratory, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyue","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hematology Laboratory, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"748585","DOI":"10.3389\/fimmu.2021.748585","article-title":"Cytokine expression of lung bacterial infection in newly diagnosed adult hematological malignancies","volume":"12","author":"Li","year":"2021","journal-title":"Front Immunol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"860526","DOI":"10.3389\/fcimb.2022.860526","article-title":"Increased cytokine levels assist in the diagnosis of respiratory bacterial infections or concurrent bacteremia in patients with non-Hodgkin\u2019s lymphoma","volume":"12","author":"Zhang","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1007\/s00134-019-05906-5","article-title":"Diagnosis of severe respiratory infections in immunocompromised patients","volume":"46","author":"Azoulay","year":"2020","journal-title":"Intensive Care Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1007\/s40121-020-00353-y","article-title":"Etiology of severe community-acquired pneumonia in adults based on metagenomic next-generation sequencing: a prospective multicenter study","volume":"9","author":"Wu","year":"2020","journal-title":"Infect Dis Ther"},{"key":"B5","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1007\/978-1-0716-0223-2_5","article-title":"Using bronchoalveolar lavage to evaluate changes in pulmonary diseases. 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