Clinical impact of pre-transplant gut microbial diversity on outcomes of allogeneic hematopoietic stem cell transplantation

N Doki, M Suyama, S Sasajima, J Ota, A Igarashi… - Annals of …, 2017 - Springer
N Doki, M Suyama, S Sasajima, J Ota, A Igarashi, I Mimura, H Morita, Y Fujioka, D Sugiyama…
Annals of Hematology, 2017Springer
Post-transplant microbial diversity in the gastrointestinal tract is closely associated with
clinical outcomes following allogeneic hematopoietic stem cell transplantation (allo-HSCT).
However, little is known about the impact of the fecal microbiota before allo-HSCT. We
analyzed fecal samples approximately 2 weeks before conditioning among 107 allo-HSCT
recipients between 2013 and 2015. Microbial analysis was performed using 16S rRNA gene
sequencing. Operational taxonomic unit-based microbial diversity was estimated by …
Abstract
Post-transplant microbial diversity in the gastrointestinal tract is closely associated with clinical outcomes following allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, little is known about the impact of the fecal microbiota before allo-HSCT. We analyzed fecal samples approximately 2 weeks before conditioning among 107 allo-HSCT recipients between 2013 and 2015. Microbial analysis was performed using 16S rRNA gene sequencing. Operational taxonomic unit-based microbial diversity was estimated by calculating the Shannon index. Patients were classified into three groups based on the diversity index: low (<2), intermediate (2, 3), and high (>3) diversity (18 (16.8%), 48 (44.9%), and 41 (38.3%) patients, respectively). There were no significant differences in the 20-month overall survival, cumulative incidence of relapse, and non-relapse mortality among three groups. The cumulative incidence of grade II to IV acute graft-versus-host disease (aGVHD) was similar among the three groups (low 55.6%; intermediate 35.4%; high 48.8%, p = 0.339, at day 100). Furthermore, we found no differences in the cumulative incidence of grade II to IV acute gastrointestinal GVHD among the three groups (low 38.9%; intermediate 21.3%; high 24.4%, p = 0.778, at day 100). Regarding the composition of microbiota before allo-HSCT, aGVHD patients showed a significantly higher abundance of phylum Firmicutes (p < 0.01) and a lower tendency for Bacteroidetes (p = 0.106) than non-aGVHD patients. Maintenance of Bacteroidetes throughout allo-HSCT may be a strategy to prevent aGVHD.
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