Longitudinal Plasma Proteomics Distinguishes Primary Immune Tolerance from Chronic Graft-versus-Host Disease After Pediatric allo-HSCT

Month 3 plasma proteomics in 32 pediatric allo-HSCT recipients shows the strongest PIT–cGvHD separation, with eight PIT-higher proteins at BH-FDR <0.05.

• Why it matters: Early molecular features distinguishing primary immune tolerance from chronic graft-versus-host disease after pediatric allo-HSCT are incompletely understood, limiting timely risk stratification.
• What they did: Longitudinal LC-MS plasma proteomics quantified 4,702 proteins at Months 1, 3, 6, 9, and 12, using timepoint-specific differential-abundance analyses and pathway/trajectory modeling.
• The result: PIT-associated programs differed by interval, while Month-3 cGvHD profiles were enriched for platelet activation, cell adhesion, transmembrane transport, and metabolic processes, supporting Month 3 as a candidate divergence interval.