{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T17:16:14Z","timestamp":1780420574801,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82400169"],"award-info":[{"award-number":["82400169"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Immunosuppressive therapy (IST) is the standard treatment for acquired pure red cell aplasia (aPRCA), but predictors of treatment response and long\u2010term prognosis remain unclear. The clinical significance of somatic mutations in aPRCA is not fully understood. We retrospectively analyzed 69 adult aPRCA patients who underwent targeted next\u2010generation sequencing of 69 genes associated with clonal hematopoiesis and myeloid neoplasms. Somatic mutations, T\u2010cell receptor (TCR) gene rearrangements, treatment response at 6\u2009months, overall survival (OS), and progression\u2010free survival (PFS) were evaluated. Somatic mutations were detected in 62.3% of patients, mainly in epigenetic regulators like\n                    <jats:italic>DNMT3A<\/jats:italic>\n                    and\n                    <jats:italic>TET2<\/jats:italic>\n                    . Although mutations did not predict 6\u2010month response to IST, higher mutation burden was associated with worse treatment outcomes (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01).\n                    <jats:italic>TP53<\/jats:italic>\n                    and\n                    <jats:italic>DNMT3A<\/jats:italic>\n                    mutations were linked to shorter OS and PFS. Survival worsened with increasing mutation numbers, while mutations in\n                    <jats:italic>TET2<\/jats:italic>\n                    ,\n                    <jats:italic>ASXL1<\/jats:italic>\n                    ,\n                    <jats:italic>GATA2<\/jats:italic>\n                    , and\n                    <jats:italic>STAT3<\/jats:italic>\n                    had no significant effect. TCR gene rearrangements were common in large granular lymphocyte leukemia\u2010associated aPRCA but did not affect treatment response or survival. Somatic mutations are common in aPRCA and reflect clonal hematopoiesis. Mutation burden is a key determinant of IST response, while\n                    <jats:italic>TP53<\/jats:italic>\n                    and\n                    <jats:italic>DNMT3A<\/jats:italic>\n                    mutations signal poorer long\u2010term outcomes. Mutational profiling may improve risk stratification and guide personalized management.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70311","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T01:39:03Z","timestamp":1775093943000},"page":"1443-1450","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Somatic Mutations and Mutation Burden Predict Treatment Response and Survival in Adult Acquired Pure Red Cell Aplasia"],"prefix":"10.1002","volume":"101","author":[{"given":"Liyan","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Hematology, General Hospital Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiqin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology, General Hospital Tianjin Medical University  Tianjin China"},{"name":"Department of Hematology, the Second Affiliated Hospital Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yansong","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Hematology, General Hospital Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyue","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Hematology, General Hospital Tianjin Medical University  Tianjin China"},{"name":"Department of Hematology, Beijing Friendship Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hematology, General Hospital Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology, General Hospital Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Hematology, General Hospital Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zonghong","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Hematology, General Hospital Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9928-9224","authenticated-orcid":false,"given":"Rong","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Hematology, General Hospital Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2402-2717","authenticated-orcid":false,"given":"Huaquan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hematology, General Hospital Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-05-717140"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021010898"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07216.x"},{"key":"e_1_2_9_5_1","volume-title":"Pure Red Cell Aplasia","author":"Mangla 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