Fecal microbiota transplantation in capsules for the treatment of steroid refractory and steroid dependent acute graft vs. host disease: A pilot study Journal Article
| Authors: | Youngster, I.; Eshel, A.; Geva, M.; Danylesko, I.; Henig, I.; Zuckerman, T.; Fried, S.; Yerushalmi, R.; Shem-Tov, N.; Fein, J. A.; Bomze, D.; Shimoni, A.; Koren, O.; Shouval, R.; Nagler, A. |
| Article Title: | Fecal microbiota transplantation in capsules for the treatment of steroid refractory and steroid dependent acute graft vs. host disease: A pilot study |
| Abstract: | Acute graft-versus-host disease (aGvHD) is a serious complication of allogeneic hematopoietic stem-cell transplantation with limited treatment options. The gut microbiome plays a critical role in aGvHD pathogenesis. Fecal microbiota transplantation (FMT) has emerged as a potential therapeutic approach to restore gut microbial diversity. In this prospective pilot study, 21 patients with steroid-resistant or steroid-dependent lower gastrointestinal aGvHD received FMT in capsule form. At 28 days after the first FMT, the overall response rate was 52.4%, with 23.8% complete and 28.6% partial responses. However, sustained responses were infrequent, with only one patient remaining aGvHD-free long-term. FMT was generally well-tolerated. Microbiome analysis revealed dysbiosis in pre-FMT patient stool samples, with distinct microbial characteristics compared to donors. Following FMT, there was an increase in beneficial Clostridiales and a decrease in pathogenic Enterobacteriales. These findings highlight the potential of FMT as a treatment option for steroid-resistant aGvHD. Trial registration number NCT #03214289. © The Author(s), under exclusive licence to Springer Nature Limited 2024. |
| Keywords: | adult; clinical article; controlled study; nonhuman; prospective study; prospective studies; steroid; hematopoietic stem cell transplantation; acute graft versus host disease; pilot study; pilot projects; patient safety; graft versus host reaction; gastrointestinal tract; graft vs host disease; steroids; overall response rate; lower gastrointestinal tract; microbiome; clostridiales; humans; human; male; female; article; fecal microbiota transplantation; dysbiosis; enterobacterales |
| Journal Title: | Bone Marrow Transplantation |
| Volume: | 59 |
| Issue: | 3 |
| ISSN: | 0268-3369 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2024-03-01 |
| Start Page: | 409 |
| End Page: | 416 |
| Language: | English |
| DOI: | 10.1038/s41409-024-02198-2 |
| PUBMED: | 38212672 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK authors: Roni Shouval -- Source: Scopus |
