{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:54:10Z","timestamp":1792108450788,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Pure red cell aplasia (PRCA) is the most frequent autoimmune cytopenia associated with thymic tumors (TTs). In a nationwide retrospective study, we included 41 patients (22 women, median age 62\u2009years). At PRCA diagnosis, the mean hemoglobin level was 6.6\u2009\u00b1\u20092.1\u2009g\/dL, and the reticulocyte count was 6\u2009\u00b1\u20095\u2009\u00d7\u200910\n                    <jats:sup>9<\/jats:sup>\n                    \/L. PRCA was diagnosed before TT (8%, median delay 52\u2009months), simultaneously (46%) or after TT (46%, median delay 34\u2009months). Fourteen patients (34%) had definite Good syndrome. Thymectomy without immunosuppressive treatment provided a single sustainable PRCA response. Twenty\u2010two patients (54%) experienced multiple PRCA relapses (Median 2). When PRCA was present at TT diagnosis, the risk of PRCA relapse was higher (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01), while TT staging, TT relapse, and Good syndrome were not associated with PRCA relapses. Corticosteroids led to a 77% initial response rate with frequent relapses during taper or at discontinuation. Cyclosporine A provided a 71% response rate. Overall response rates and time to response were similar with corticosteroids and cyclosporine A. Sirolimus led to a 50% response rate in refractory cases. Severe infectious events requiring hospitalizations were frequent (44%). After a mean follow\u2010up of 50\u2009months, five patients (12%) died, three of whom died from TT relapse. Good syndrome was not significantly associated with an increased risk of infection, PRCA relapse, or death. Our findings highlight the severe phenotype of the association of TT and PRCA. While most patients achieve PRCA response under immunosuppressive therapy, high infection incidence and thymoma relapse are responsible for severe morbidity.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70068","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T10:45:32Z","timestamp":1757328332000},"page":"2230-2237","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pure Red Cell Aplasia Associated With Thymic Tumors, a Nationwide Retrospective Study"],"prefix":"10.1002","volume":"100","author":[{"given":"Myl\u00e8ne","family":"Hemmer","sequence":"first","affiliation":[{"name":"M\u00e9decine Interne, H\u00f4pital Estaing, Centre Hospitalier Universitaire de Clermont\u2010Ferrand  Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Moinard","sequence":"additional","affiliation":[{"name":"H\u00e9matologie Biologique, H\u00f4pital Estaing, Centre Hospitalier Universitaire de Clermont\u2010Ferrand  Clermont\u2010Ferrand France"},{"name":"EA7453 CHELTER, Universit\u00e9 Clermont\u2010Auvergne  Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Lambotte","sequence":"additional","affiliation":[{"name":"AP\u2010HP, Paris Saclay, Department of Internal Medicine and Clinical Immunology, Bic\u00eatre Hospital  Le Kremlin\u2010Bicetre France"},{"name":"Universit\u00e9 Paris\u2010Saclay, Inserm, CEA, Center for Immunology of Viral, Auto\u2010Immune, Hematological, Bacterial Diseases (IMVA\u2010HB\/IDMIT\/UMRS1184)  Le Kremlin Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9888-2528","authenticated-orcid":false,"given":"Marion","family":"Malphettes","sequence":"additional","affiliation":[{"name":"Service d'Immuno\u2010Pathologie Clinique, Assistance Publique\u2014H\u00f4pitaux de Paris, H\u00f4pital Saint Louis  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Terriou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Immunology Centre de R\u00e9f\u00e9rence Des Maladies Autoimmunes Syst\u00e9miques Rares du Nord et Nord\u2010Ouest de France (CeRAINO), CHRU  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Lioger","sequence":"additional","affiliation":[{"name":"Service de m\u00e9decine Interne et Polyvalente 2, Unit\u00e9 de Recherche Clinique, Centre Hospitalier de Blois  Blois France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Le Guenno","sequence":"additional","affiliation":[{"name":"M\u00e9decine Interne, H\u00f4pital Estaing, Centre Hospitalier Universitaire de Clermont\u2010Ferrand  Clermont\u2010Ferrand 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