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Newborn screening (NBS) using T\u2010cell receptor excision circles (TREC) has been adopted globally, with very few countries incorporating kappa recombination excision circles (KREC) to also detect early B\u2010cell development disorders, such as X\u2010linked agammaglobulinemia (XLA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of a 2\u2010year pilot SCID NBS program in the Czech Republic, emphasising the utility of combined TREC\/KREC screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between January 2022 and December 2023, a dual TREC\/KREC NBS pilot was conducted across the Czech Republic, alongside spinal muscular atrophy (SMA) screening. Approximately 200,000 newborns were screened using quantitative real\u2010time PCR on dried blood spots collected 48\u201372\u2009h after birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The pilot referred 58 newborns, identifying 21 cases of IEI, including two SCID cases, with an overall incidence of TREC\/KREC screenable IEI of 10.5\/100,000 newborns. SCID incidence was 1\/100,000. KREC screening proved invaluable, detecting 10 cases of congenital agammaglobulinemia including novel non\u2010XLA forms, which increased the estimated incidence of agammaglobulinemia in the Czech Republic sixfold. Over one\u2010third of low KREC results were linked to maternal immunosuppression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Czech pilot demonstrated the effectiveness of integrated TREC\/KREC NBS in detecting both T\u2010 and B\u2010cell immunodeficiencies. As of 2024, SCID and SMA screening are included in the nationwide NBS, with KREC screening significantly improving early detection of B\u2010cell disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.70100","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T03:54:44Z","timestamp":1746417284000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Beyond TREC: Pivotal role of tandem TREC\/KREC assay in Czech SCID NBS pilot programme"],"prefix":"10.1111","volume":"36","author":[{"given":"Mark\u00e9ta","family":"Bloomfield","sequence":"first","affiliation":[{"name":"Department of Immunology, 2nd Faculty of Medicine Charles University and University Hospital in Motol  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Hlav\u00e1\u010dkov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Clinical 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