{
  "abstract": "Objective: Autoimmune hemolytic anemia (AIHA) represents a heterogeneous group of autoimmune disorders, with limited large-scale real-world evidence from Asian populations. This study aimed to characterize the clinical characteristics, treatment patterns, and long-term outcomes of patients with warm AIHA (wAIHA) and mixed AIHA (mAIHA).\n\nMethods: This single-center retrospective study screened 629 patients with AIHA hospitalized in China between 2014 and 2023. After excluding 32 patients with cold AIHA and 31 with DAT-negative AIHA, 566 patients (449 wAIHA and 117 mAIHA) were included, with a median follow-up of 57 months.\n\nResults: Compared with wAIHA, mAIHA patients presented with earlier onset, poorer bone marrow compensation, and cold AIHA-like features despite comparable hemoglobin levels. Secondary AIHA was more prevalent in mAIHA (39.3% vs. 22.5%). Glucocorticoids remained the first-line treatment with similar response rates in both subtypes, while rituximab was the predominant second-line therapy. Treatment strategies and outcomes with multiple emerging therapies were also summarized. Median event-free survival was 17 months, with relapses mainly occurring during treatment tapering or infections. Estimated overall survival (OS) rates at 1, 3, and 5 years were 96%, 92%, and 89%, respectively, with infections and disease progression being leading causes of mortality. Independent risk factors associated with OS included age ≥60, hemoglobin at onset <6 g/dL, bone marrow responsiveness index <121, male sex, and an IgM+IgA-mediated serological pattern, whereas cold agglutinin titers demonstrated limited value in predicting OS or treatment response.\n\nConclusions: mAIHA and wAIHA share comparable glucocorticoid response and long-term survival despite distinct clinical and serological characteristics. This large real-world cohort delineates the profiles of wAIHA and mAIHA and identifies baseline factors associated with OS to support individualized management. Emerging therapies present promising prospects in AIHA management.",
  "abstract_shown": true,
  "affiliations": [
    "State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College",
    "Tianjin Institutes of Health Science"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Junan Zhang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Yuan Li"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Jiewen Qiu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Yizhou Zheng"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Meili Ge"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Fengkui Zhang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Jun Shi"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xin Zhao"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5ajfybqxva0r1.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1931581",
  "fulltext_url": "https://europepmc.org/articles/PMC13711130",
  "id": "5ajfybqxva0r1",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1931581/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2720|Blood groups and transfusion"
    ]
  ],
  "openalex": "W7221572535",
  "pdf_url": "https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1931581/pdf",
  "pmcid": "PMC13711130",
  "pmid": "42948377",
  "published": "2026-10-12",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/5ajfybqxva0r1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:15Z",
      "native_id": "10.3389/fimmu.2026.1931581",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1931581/full"
    },
    {
      "first_seen": "2026-10-31T00:20:34Z",
      "native_id": "MED:42948377",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948377"
    },
    {
      "first_seen": "2026-10-31T12:21:57Z",
      "native_id": "PMC13711130",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fimmu.2026.1931581"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "issn:1664-3224",
      "subfield": "immunology"
    }
  ],
  "title": "Clinical characteristics, treatment patterns and long-term outcomes of warm and mixed autoimmune hemolytic anemia: insights from a real-world study",
  "title_text": "Clinical characteristics, treatment patterns and long-term outcomes of warm and mixed autoimmune hemolytic anemia: insights from a real-world study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:57Z",
  "url": "https://research.draconitic.com/paper/5ajfybqxva0r1",
  "venue": "Frontiers in Immunology",
  "versions": []
}