Microbiota injury related to Conditioning Regimens

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