Endothelial Damage as a Pivotal Driver of Treatment Toxicities in Pediatric Hematology–Oncology: From Biomarker Discovery to Therapeutic Innovation

Endothelial injury is increasingly recognized as a key mediator of diverse treatment-related toxicities across pediatric hematology–oncology. As chemotherapy, immunotherapy, radiation therapy, and hematopoietic stem cell transplantation continue to advance, their complex interactions with endothelial health in children have become more apparent. Complications such as sinusoidal obstruction syndrome/veno-occlusive disease, transplant-associated thrombotic microangiopathy, capillary leak syndrome, severe mucositis, and acute and chronic graft-versus-host disease are now understood to be strongly influenced by endothelial dysfunction. This evolving landscape is further shaped by factors such as infectious exposures, administered drugs, nutritional status, and the unique physiology of pediatric development. Although recent progress in biomarker discovery, mechanistic research, and supportive care has been significant, substantial gaps remain in integrating these insights into cohesive models for risk prediction, early detection, and targeted intervention.This Research Topic aims to provide a comprehensive forum for advancing knowledge on how endothelial damage drives the full spectrum of treatment toxicities in children with hematologic and oncologic conditions. Our goal is to bring together basic, translational, and clinical research that enables actionable progress, from identifying and validating novel biomarkers and risk indices, to refining mechanistic understanding, to developing and implementing effective preventive and therapeutic approaches. We also seek to foster interdisciplinary dialogue around practical challenges, including incorporation of endothelial markers into clinical workflows, adaptation of strategies across varying resource settings, and promotion of equitable access to emerging innovations. Key unanswered questions include how best to identify high-risk patients early, personalize treatment strategies, and monitor response and recovery to reduce morbidity and improve long-term outcomes.This Research Topic will focus on children, from neonates through adolescents, experiencing endothelial injury and related toxicities in hematology, oncology, and transplantation contexts. We welcome submissions addressing a broad range of mechanisms, interventions, and clinical consequences. Potential themes include, but are not limited to:• Novel and emerging biomarkers (clinical, laboratory, imaging, and multi-omic) for risk stratification and monitoring• Mechanistic studies of endothelial injury, including genetic, proteomic, metabolic, and microbiome contributors• Influence of supportive care, nutrition, administered drugs, and host–environment interactions on endothelial health• Development and evaluation of pharmacologic, biologic, and supportive interventions to prevent or mitigate endothelial damage• Real-world implementation science, health-system integration, outcome measurement, and quality-improvement initiatives• Approaches to health equity, resource-adapted diagnostics, and scalable innovations for global pediatric oncologyWe invite original research, systematic reviews, brief reports, clinical protocols, study designs, perspectives, and guideline articles. Topic editors: Edoardo Muratore, Daniel Turudic Source: https://www.frontiersin.org/research-topics/81802/endothelial-damage-as-a-pivotal-driver-of-treatment-toxicities-in-pediatric-hematology-oncology-from-biomarker-discovery-to-therapeutic-innovation