- Research Article
- 10.1111/ejh.70104
Impact of CD34+ Bone Marrow Cell Heterogeneity and HMOX1 Promoter Polymorphism on Neutrophil Engraftment in Pediatric Patients Undergoing Hematopoietic Stem Cell Transplantation.
- Dec 30, 2025
- European journal of haematology
- Karolina Bukowska-Strakova + 9 more +9
Hematopoietic stem cell transplantation (HSCT) is a therapeutic option for various pediatric diseases. In this study, we analyzed 52 pediatric patients undergoing allogeneic HSCT to determine how the content of myeloid and lymphoid CD34+ progenitor cells, as well as HMOX1 promoter polymorphisms, affects neutrophil (NE) and platelet engraftment (PE). We found that NE was significantly accelerated in patients who received a higher dose of CD34+ myeloid cells (> 4 × 106/kg), while lymphoid progenitors had no impact on engraftment. PE was not affected by any CD34+ cell subtype. Moreover, in a subset of 28 patients, the presence of short HMOX1 promoter alleles in recipients, but not in donors, was associated with delayed NE, particularly during early post-transplantation. These results highlight the importance of graft composition-specifically myeloid CD34+ cell dose-and recipient HMOX1 genotype in determining the kinetics of neutrophil recovery. This may offer a new perspective for graft optimization and potential use of HO-1-targeted therapies to enhance engraftment.
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