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