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Coco de Koning

Coco de Koning

Immune function reconstitution after allogeneic hematopoietic stem cell transplantation in children

There is an urgent need to enhance survival post-hematopoietic cell transplantation (HCT), as still 30-50% of pediatric HCT-recipients die from immune-related complications, as graft-versus-host-disease, infections, or leukemia relapse. Current protocols to treat immune-related complications are challenged by limited treatment options, and often come too late to have an adequate effect. Novel targets for therapy to control immune-related complications and better predictors for individual outcome are imperative to enhance event-free survival after HCT.

Immune cell reconstitution has been linked to morbidity and mortality after HCT, but cell counts only do not allow for individual outcome prediction. The solution to this problem is to not only focus on the quantity of immune reconstitution, but on the quality of immune cell function. This will provide better understanding of immune-related complication development at an individual level. Novel targets for therapies to reduce immune-related complications after HCT lie in deciphering the cellular pathways involved in immune cell function/dysfunction.

My research focuses on deciphering the dynamics of immune cell function/dysfunction in the development of immune-related complications after HCT in children. This not only allows for identification of immune-based predictors for pre-emptive personalized treatment adjustment to enhance event-free survival, but also provides novel targets for therapies to better control immune-related complications.