ABSTRACT This study aimed to explore the differences of peripheral blood ( PB ) and bone marrow serum lipidomic profiles in severe aplastic anemia ( SAA ) patients and their significance in predicting earlier immunosuppressive therapy ( IST ) response. A cohort of 11 newly diagnosed SAA patients and 15 healthy controls were enrolled between June 2020 and November 2022, and six of the SAA patients received ATG ‐based IST . PB and BM serum were collected for further LC – MS / MS analysis. Compared to donors, SAA patients exhibited more pronounced abnormalities in lipid metabolism profiles within BM serum relative to PB serum. Specifically, elevated levels of free fatty acids ( FA ), fatty acid esters of hydroxyl fatty acids ( FAHFA ), and phosphatidylserine ( PS ) were noted in the BM serum of SAA patients. Following treatment, there was a noted increase in acylcarnitine ( ACar ), hexosylceramide non‐hydroxy fatty acid‐sphingosine ( HexCer ‐ NS ), and sulfur hexosyl ceramide hydroxy fatty acid ( SHexCer ), while levels of lysophosphatidylcholine ( LPC ) and oxidized phosphatidylcholine ( OxPC ) diminished, particularly in complete or partial response ( CR / PR ) patients. Acknowledging the changes of BM lipidomics may contribute to earlier prediction of ATG ‐based IST response in SAA patients.
Sun et al. (2026) studied this question.