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
Notes: Article -- Export Date: 1 April 2021 -- Source: Scopus
Citation Impact
MSK Authors
  1. Sergio Andres Giralt
    786 Giralt
  2. Craig Steven Sauter
    282 Sauter
  3. Miguel-Angel Perales
    617 Perales
  4. Heather Jolie Landau
    271 Landau
  5. Ying Taur
    130 Taur
  6. Alexander Meyer Lesokhin
    171 Lesokhin
  7. David Chung
    123 Chung
  8. Molly Anna Maloy
    255 Maloy
  9. Sean McCarthy Devlin
    459 Devlin
  10. Parastoo Bahrami Dahi
    195 Dahi
  11. Jonathan U Peled
    98 Peled
  12. Gunjan Lalitchandra Shah
    201 Shah
  13. Niloufer Khan
    27 Khan
  14. Emily Fontana
    22 Fontana
  15. Antonio LC Gomes
    38 Gomes
  16. Kate Ann Markey
    25 Markey
  17. Annelie G Clurman
    19 Clurman
  18. Gabriel Armijo
    7 Armijo
  19. Anqi Dai
    6 Dai