Gut Microbiota Influences Survival After Pediatric Stem Cell Transplant

WEDNESDAY, Aug. 16, 2023 (HealthDay News) -- For pediatric patients, gut microbiota diversity and composition before allogeneic hematopoietic stem cell transplantation (allo-HSCT) influences survival and likelihood of acute graft-versus-host disease, according to a study published online Aug. 10 in Blood.

Noting that there is an association between gut microbiota diversity and survival after allo-HSCT in adults, Riccardo Masetti, M.D., Ph.D., from the University of Bologna in Italy, and colleagues analyzed stool samples from a multicenter cohort of 90 pediatric allo-HSCT recipients using 16S rRNA amplicon sequencing to profile the gut microbiota and estimate diversity. The ecological structure of the gut microbiota was characterized; patients were stratified into higher- and lower-diversity groups pretransplantation and at neutrophil engraftment.

The researchers found that the group with higher diversity prior to transplantation had a higher probability of overall survival and lower incidence of grade II to IV and III to IV acute graft-versus-host disease. The two groups had no significant difference in relapse-free survival. Higher relative abundance of potentially health-related families, such as Ruminococcaceae and Oscillospiraceae, characterized the higher-diversity group. An overabundance of Enterococcaceae and Enterobacteriaceae was seen in the lower-diversity group. In the higher-diversity group, short-chain fatty acid producers such as Blautia, Faecalibacterium, Roseburia, and Bacteroides were keystones, whereas in the lower-diversity group, Enterococcus, Escherichia-Shigella, and Enterobacter were the keystones.

"Our study provides the first evidence of a relationship between pretransplant microbial diversity in the intestinal tract and post-transplant survival in children," Masetti said in a statement. "This finding suggests that interventions to improve microbial diversity before transplantation could help more children survive."

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