The gut microbiome plays a critical role in modulating the immune response, influencing outcomes of allogeneic transplantation, a life-saving treatment for relapsed/refractory leukemia and lymphoma. However, this treatment comes with significant complications that can limit is efficacy. Understanding and leveraging the immunomodulatory potential of the microbiome is crucial for optimizing cancer therapy outcomes. However, the mechanisms underlying the microbiome's influence on outcomes post-transplant, especially in pediatric patients, remain insufficiently understood.