Immune reconstitution in pediatric stem-cell transplantation

Hematopoietic stem-cell transplantation (HSCT) has successfully been used t o cure many pediatric disorders. However, the immunologic alterations assoc iated with transplantation result in profound immunodeficiencies in the tra nsplant recipient, resulting in significant infectious morbidity and mortal ity. The precarious process of immune reconstitution in the transplant reci pient is neither instantaneous nor complete, but influenced by multiple fac tors such as graft-versus-host disease (GVHD), conditioning regimen, patien t age and underlying disease. Studies in pediatric HSCT have revealed uniqu e attributes of immune recovery in pediatric transplant recipients. Future studies addressing these findings are needed to complement novel immunother apies emerging from the field of transplant immunology.