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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Alloimmunity and Transplantation
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1517387

Predicted Indirectly Recognizable HLA Epitopes (PIRCHE) Scores and Clinical Outcomes after Haploidentical Stem Cell Transplantation in Pediatric Patients with Relapsed Neuroblastoma

Provisionally accepted
Eun Seop Seo Eun Seop Seo 1,2In Hwa Jeong In Hwa Jeong 3Hee Young Ju Hee Young Ju 2*Ju Kyung Hyun Ju Kyung Hyun 2*Ji Won Lee Ji Won Lee 2*Hee Keon Yoo Hee Keon Yoo 2*Won Young Heo Won Young Heo 2*Ki Woong Sung Ki Woong Sung 2*Hee Won Cho Hee Won Cho 2*Eun-Suk Kang Eun-Suk Kang 2*
  • 1 Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
  • 2 Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
  • 3 Dong-a University Hospital, Busan, Republic of Korea

The final, formatted version of the article will be published soon.

    The Predicted Indirectly ReCognizable HLA Epitopes (PIRCHE) model is a recently developed algorithm that predicts indirect T-cell recognition by calculating the number of such epitopes in donor-recipient pairs. Methods: In this study, the clinical significance of PIRCHE was evaluated in pediatric patients with relapsed/progressed neuroblastoma undergoing haploidentical stem cell transplantation (haplo-SCT).Results: A higher PIRCHE-I score was associated with faster platelet recovery (P = 0.007) and lower incidence of hemorrhagic cystitis (13% vs. 41%, P = 0.028) and invasive fungal infections (0% vs. 18%, P = 0.045). Additionally, a higher PIRCHE-I score was significantly associated with better overall survival (OS) (HR 0.57, 95% CI 0.34-0.97, P = 0.038). A higher PIRCHE-II score was associated with better OS (HR 0.57, 95% CI 0.34-0.94, P = 0.028) and reduced progression (HR 0.48, 95% CI 0.30-0.77, P = 0.002). When combined, the PIRCHE-I and PIRCHE-II scores demonstrated an even stronger association with improved OS (HR 0.35, 95% CI 0.15-0.82, P = 0.016). Multivariable analysis confirmed that a higher combined PIRCHE-I and PIRCHE-II score was independently associated with improved OS (combined PIRCHE score HR 0.22, 95% CI 0.06-0.79, P = 0.021), and a higher PIRCHE-II score was significantly associated with reduced progression (HR 0.42, 95% CI 0.25-0.70, P < 0.001).In conclusion, higher PIRCHE-I and PIRCHE-II scores are linked to better survival outcomes and reduced complications in pediatric haplo-SCT neuroblastoma patients.Incorporating PIRCHE scores into donor selection is expected to optimize transplant outcomes.

    Keywords: Neuroblastoma, PIRCHE, Haplo identical hematopoietic stem cell transplantation, Relapse /Refractory, HLA mismatch

    Received: 26 Oct 2024; Accepted: 06 Jan 2025.

    Copyright: © 2025 Seo, Jeong, Ju, Hyun, Lee, Yoo, Heo, Sung, Cho and Kang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Hee Young Ju, Samsung Medical Center, Sungkyunkwan University, Seoul, 06351, Republic of Korea
    Ju Kyung Hyun, Samsung Medical Center, Sungkyunkwan University, Seoul, 06351, Republic of Korea
    Ji Won Lee, Samsung Medical Center, Sungkyunkwan University, Seoul, 06351, Republic of Korea
    Hee Keon Yoo, Samsung Medical Center, Sungkyunkwan University, Seoul, 06351, Republic of Korea
    Won Young Heo, Samsung Medical Center, Sungkyunkwan University, Seoul, 06351, Republic of Korea
    Ki Woong Sung, Samsung Medical Center, Sungkyunkwan University, Seoul, 06351, Republic of Korea
    Hee Won Cho, Samsung Medical Center, Sungkyunkwan University, Seoul, 06351, Republic of Korea
    Eun-Suk Kang, Samsung Medical Center, Sungkyunkwan University, Seoul, 06351, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.