Scott MKD, et al. - Researchers determined if a higher risk of poor outcomes among patients with idiopathic pulmonary fibrosis could be detected using a specific immune cell type. They also sought for validation of findings by using cytometry and electronic health records. They performed a discovery analysis using transcriptome data from patients with idiopathic pulmonary fibrosis. For validation, they used peripheral blood mononuclear cell samples from two independent cohorts (COMET and Yale). Findings in the discovery analysis showed an association of estimated CD14+ classical monocyte percentages above the mean with shorter transplant-free survival times, whereas no link was evident for higher percentages of T cells and B cells. A higher risk for poor outcomes was observed in patients with higher monocyte counts in two validation cohorts. Overall, it may be valid to include monocyte count into the clinical evaluation of patients with idiopathic pulmonary fibrosis and other fibrotic disorders.