Survival analysis of 133 hub genes identified 13 genes significantly associated with PRCA prognosis, specifically CACNA1H, BICDL2, ABHD17A, ARHGAP33, AP5Z1, ARHGEF16, ASMTL-AS1, ATAD3B, ATG16L2, AXIN1, LLCFC1, LENG8, and KMT2B, which were considered biomarkers for the immunosuppressive microenvironment. Here, ASMTL-AS1 is linked to pure red-cell aplasia.