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Consistently low blood lymphocytes in smokers are associated with worse clinical outcomes.

Background: Myeloid cell types in blood leukocyte counts have been related to cross-sectional and longitudinal lung function in smokers. However, the possible changes in blood lymphocyte counts and their relation to clinical outcomes in smokers have not been studied yet. Aim: To investigate the blood lymphocytes (BL) numbers, their consistency over time, and their possible effect in clinical outcomes in smokers followed long term. Methods: 511 smokers (302 with and 209 without COPD) were followed clinically, functionally, and with blood cells count annually for 5 years. 1800 cells/µL was used as the cut-off to define low or high BL. Results: Mean BL value in the 5 yearly samples, and in each sample, were consistently lower in smokers with COPD than in those without (mean ±SD: 1980±755 vs 2450±974 cells/µL, p Conclusions: Smokers with COPD have a consistent lymphopenia, which is associated with decreased lung function, increased rate of exacerbations and increased mortality. The decreased blood lymphocytes might be secondary to the known accumulation of lymphocytes in lung tissue in COPD.