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Gut Microbiota Influences Survival After Pediatric Stem Cell Transplant

Diversity and composition of gut microbiota before transplantation associated with survival

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Aug. 16, 2023 (HealthDay News) — For pediatric patients, gut microbiota diversity and composition before allogeneic hematopoietic stem cell transplantation (allo-HSCT) influences survival and likelihood of acute graft-versus-host disease, according to a study published online Aug. 10 in Blood.

Noting that there is an association between gut microbiota diversity and survival after allo-HSCT in adults, Riccardo Masetti, M.D., Ph.D., from the University of Bologna in Italy, and colleagues analyzed stool samples from a multicenter cohort of 90 pediatric allo-HSCT recipients using 16S rRNA amplicon sequencing to profile the gut microbiota and estimate diversity. The ecological structure of the gut microbiota was characterized; patients were stratified into higher- and lower-diversity groups pretransplantation and at neutrophil engraftment.

The researchers found that the group with higher diversity prior to transplantation had a higher probability of overall survival and lower incidence of grade II to IV and III to IV acute graft-versus-host disease. The two groups had no significant difference in relapse-free survival. Higher relative abundance of potentially health-related families, such as Ruminococcaceae and Oscillospiraceae, characterized the higher-diversity group. An overabundance of Enterococcaceae and Enterobacteriaceae was seen in the lower-diversity group. In the higher-diversity group, short-chain fatty acid producers such as Blautia, Faecalibacterium, Roseburia, and Bacteroides were keystones, whereas in the lower-diversity group, Enterococcus, Escherichia-Shigella, and Enterobacter were the keystones.

“Our study provides the first evidence of a relationship between pretransplant microbial diversity in the intestinal tract and post-transplant survival in children,” Masetti said in a statement. “This finding suggests that interventions to improve microbial diversity before transplantation could help more children survive.”

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