Shouval R, Waters NR, Gomes ALC, et al. Conditioning Regimens Are Associated with Distinct Patterns of Microbiota Injury in Allogeneic Hematopoietic Cell Transplantation. Clinical Cancer Research. 2022; (doi: 10.1158/1078-0432.CCR-22-1254).

Scientists confirmed their hypothesized connection between the degree of gut microbiota injury and the interaction of preparative conditioning regimens for allogeneic hematopoietic cell transplant (allo-HCT) recipients. Stool samples collected from 1,188 patients from 20 days before allo-HCT to up to 30 days after their transplant were evaluated with 16S rRNA sequencing. Microbiota perturbation was measured by α-diversity changes, while diversity loss was classed into three tiers of conditioning-associated microbiota injury (CMBI). The greatest injury loss (CMBI III) correlated with high-intensity regimens such as total body irradiation (TBI)-thiotepa-cyclophosphamide, while low-grade injury (CMBI I) was associated with the non-myeloablative regimen fludarabine-cyclophosphamide with low-dose TBI (Flu/Cy/TBI200). The risk of acute graft-versus-host disease corresponded with the degree of CMBI. Flu/Cy/TBI200 best maintained pre-transplant microbial compositions, while other regimens reduced commensal bacteria and increased Enterococcus levels.

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Tags: AlloHCT, patient care, transplantation, Cellular therapy, Survival, Allogeneic, clinical, Research, allogeneic HCT, Allo HCT, transplatation