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

Chronic graft-versus-host disease (cGvHD) remains a major cause of morbidity after pediatric allogeneic hematopoietic stem cell transplantation (HSCT), but the early plasma molecular features associated with primary immune tolerance (PIT) versus cGvHD are incompletely understood. We performed longitudinal LC-MS plasma proteomics in 32 pediatric allo-HSCT recipients sampled at Months 1, 3, 6, 9, and 12 after transplantation, quantifying 4,702 proteins. Across timepoint-specific differential-abundance analyses, Month 3 showed the strongest observed PIT-cGvHD proteomic separation and was selected

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