Fecal microbiota diversity disruption and clinical outcomes after auto-HCT: A multicenter observational study Journal Article
| Authors: | Khan, N.; Lindner, S.; Gomes, A. L. C.; Devlin, S. M.; Shah, G. L.; Sung, A. D.; Sauter, C. S.; Landau, H. J.; Dahi, P. B.; Perales, M. A.; Chung, D. J.; Lesokhin, A. M.; Dai, A.; Clurman, A.; Slingerland, J. B.; Slingerland, A. E.; Brereton, D. G.; Giardina, P. A.; Maloy, M.; Armijo, G. K.; Rondon-Clavo, C.; Fontana, E.; Bohannon, L.; Ramalingam, S.; Bush, A. T.; Lew, M. V.; Messina, J. A.; Littmann, E.; Taur, Y.; Jenq, R. R.; Chao, N. J.; Giralt, S.; Markey, K. A.; Pamer, E. G.; van den Brink, M. R. M.; Peled, J. U. |
| Article Title: | Fecal microbiota diversity disruption and clinical outcomes after auto-HCT: A multicenter observational study |
| Abstract: | We previously described clinically relevant reductions in fecal microbiota diversity in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). Recipients of high-dose chemotherapy and autologous HCT (auto-HCT) incur similar antibiotic exposures and nutritional alterations. To characterize the fecal microbiota in the auto-HCT population, we analyzed 1161 fecal samples collected from 534 adult recipients of auto-HCT for lymphoma, myeloma, and amyloidosis in an observational study conducted at 2 transplantation centers in the United States. By using 16S ribosomal gene sequencing, we assessed fecal microbiota composition and diversity, as measured by the inverse Simpson index. At both centers, the diversity of early pretransplant fecal microbiota was lower in patients than in healthy controls and decreased further during the course of transplantation. Loss of diversity and domination by specific bacterial taxa occurred during auto-HCT in patterns similar to those with allo-HCT. Above-median fecal intestinal diversity in the periengraftment period was associated with decreased risk of death or progression (progression-free survival hazard ratio, 0.46; 95% confidence interval, 0.26-0.82; P =.008), adjusting for disease and disease status. This suggests that further investigation into the health of the intestinal microbiota in auto-HCT patients and posttransplant outcomes should be undertaken. © 2021 American Society of Hematology Key Points: • Microbiota injury is observed in recipients of auto-HCT. • Lower periengraftment diversity in fecal samples is associated with worse overall and progression-free survival in auto-HCT patients. © 2021 American Society of Hematology |
| Keywords: | adult; cancer chemotherapy; cancer survival; controlled study; gene sequence; major clinical study; busulfan; united states; gemcitabine; cytarabine; ibritumomab tiuxetan; rituximab; follow up; progression free survival; multiple myeloma; etoposide; cohort analysis; bendamustine; cyclophosphamide; melphalan; amyloidosis; carmustine; thiotepa; hodgkin disease; nonhodgkin lymphoma; neutrophil; immunoglobulin g; multicenter study; transplantation conditioning; allogeneic hematopoietic stem cell transplantation; observational study; intestine flora; rna 16s; graft recipient; sample; immunoglobulin a; clinical outcome; microbial diversity; human; male; female; priority journal; article; fecal microbiota transplantation; bacteriotherapy |
| Journal Title: | Blood |
| Volume: | 137 |
| Issue: | 11 |
| ISSN: | 0006-4971 |
| Publisher: | American Society of Hematology |
| Date Published: | 2021-03-18 |
| Start Page: | 1527 |
| End Page: | 1537 |
| Language: | English |
| DOI: | 10.1182/blood.2020006923 |
| PUBMED: | 33512409 |
| PROVIDER: | scopus |
| PMCID: | PMC7976512 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 April 2021 -- Source: Scopus |
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