Pre-HCT gut microbiota diversity and outcomes in children

Masetti R, Leardini D, Muratore E, et al. Gut Microbiota Diversity Before Allogeneic Hematopoietic Stem Cell Transplantation as Predictor of Mortality in Children. Blood. 2023; (doi: 10.1182/blood.2023020026).

An analysis of pre-transplantation (pre-HCT) gut microbiota (GM) diversity found a correlation with improved overall survival and fewer occurrences of acute graft versus host disease (aGVHD) among pediatric patients. Using 16S rRNA amplicon sequencing, pre-HCT stool samples from 90 children were analyzed. Patients were divided into higher- and lower-diversity groups at pre-HCT and at neutrophil engraftment. The pre-HCT group with higher GM diversity had a higher likelihood of overall survival (88.9±5.7 standard error [SE] vs 62.7±8.2 [SE], p=0.011) and lower incidence of grade II-IV aGVHD (20.0±6.0 [SE] vs 44.4±7.4 [SE], p=0.017) and grade III-IV aGvHD (2.2±2.2 [SE] vs 20.0±6.0 [SE], p=0.007). Between the two groups, there was no significant difference in relapse-free survival (80.0±6.0 [SE] vs 55.4±0.8 [SE], p=0.091). There were higher relative levels of potentially health-related families, such as Ruminococcaceae and Oscillospiraceae, in the higher-diversity group, while levels of Enterococcaceae and Enterobacteriaceae were elevated in the lower-diversity group. Keystones in the higher-diversity group were short-chain fatty acid producers like Blautia, Faecalibacterium, Roseburia, and Bacteroides, while Enterococcus, Escherichia-Shigella, and Enterobacter were keystones in the lower-diversity group.

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Tags: GVHD, pediatric, Graft versus host disease, Acute GVHD, aGVHD, Clinical Research, graft-vs-host disease

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