Immune profiling in pediatric patients

Over the years, allogeneic hematopoietic stem cell transplantation (HCT) has gained importance in the clinical practice for treating children with malignant and non-malignant diseases, such as primary immunodeficiencies or multisystem disorders. According to the latest statistical report, the European Union has noted growing tendency in HCT since 2018, when more than 30 000 stem cell transplantations were performed. The main objective of HCT is to replace the patientspatient’s bone marrow cells with stem cells of an eligible donor. Prior to HCT, patients receive a conditioning regimen consisting of chemotherapies or total body irradiation to deplete the bone marrow, suppress the immune system and make space for the donor cells. After successful engraftment of the donor stem cells, the immune system needs to recover. Our previously published findings suggest that early adequate immune recovery after HCT, tends to improve patients’ outcome. Specifically, we showed that CD4+ T cells play a key role in immune reconstitution; however, the exact mechanisms behind it are still unclear. Therefore, my project focuses on understanding the mechanisms for functional immune reconstitution post-HCT in children; and characterize what variables contribute to adequate immune reconstitution, and a subsequent positive prognosis. The complete immune profile of our patients, could be a step forward to a clinically applicable patient-outcome predictive model that could revolutionize current HCT practice.

Hannah Kunstek