Good's syndrome and infections in a large retrospective cohort of thymoma

Good's syndrome (GS) is an immunodeficiency associated with thymoma characterized by hypogammaglobulinemia. The co-existence of recurrent infections may be associated with quality of life and overall survival. Despite its relevance, the impact of GS on patients with thymoma has rarely been studied in large cohorts.

This is a retrospective cohort study of patients with pathologically confirmed thymoma recruited between May 2010 and November 2024. Data on peripheral immune profile, infections, and paraneoplastic syndrome (PNS) were collected and analyzed.

Of 1001 patients with thymoma, we ultimately included 158 patients who underwent peripheral immune profiling. The prevalence of GS was 45.6% (72/158), and the infections were reported in 43.69% (69/158). Infection rates were higher in the GS group than in non-GS group (50% versus 32.72%, P = 0.0384). Among the 121 pathogens identified from this cohort, bacteria were the most prevalent (52.07%, 63/121), followed by fungi (34.71%, 42/121) and virus (13.22%, 16/121). Patients with infections had significantly lower overall survival compared with those without infections (P < 0.001). In addition, patients with multiple PNS had poorer survival than those with a single PNS (P < 0.001). No significant difference in overall survival was found between the GS and the non-GS groups.

GS and infections are prevalent in patients with thymoma. Infections and multiple PNS were associated with poorer survival outcomes. These findings highlight the importance of early detection and intervention for improving prognosis and long-term survival in patients with thymoma.