Fecal microbiota diversity disruption and clinical outcomes after auto-HCT: a multicenter observational study.

Journal Article (Journal Article;Multicenter Study)

We previously described clinically relevant reductions in fecal microbiota diversity in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). Recipients of high-dose chemotherapy and autologous HCT (auto-HCT) incur similar antibiotic exposures and nutritional alterations. To characterize the fecal microbiota in the auto-HCT population, we analyzed 1161 fecal samples collected from 534 adult recipients of auto-HCT for lymphoma, myeloma, and amyloidosis in an observational study conducted at 2 transplantation centers in the United States. By using 16S ribosomal gene sequencing, we assessed fecal microbiota composition and diversity, as measured by the inverse Simpson index. At both centers, the diversity of early pretransplant fecal microbiota was lower in patients than in healthy controls and decreased further during the course of transplantation. Loss of diversity and domination by specific bacterial taxa occurred during auto-HCT in patterns similar to those with allo-HCT. Above-median fecal intestinal diversity in the periengraftment period was associated with decreased risk of death or progression (progression-free survival hazard ratio, 0.46; 95% confidence interval, 0.26-0.82; P = .008), adjusting for disease and disease status. This suggests that further investigation into the health of the intestinal microbiota in auto-HCT patients and posttransplant outcomes should be undertaken.

Full Text

Duke Authors

Cited Authors

  • Khan, N; Lindner, S; Gomes, ALC; Devlin, SM; Shah, GL; Sung, AD; Sauter, CS; Landau, HJ; Dahi, PB; Perales, M-A; Chung, DJ; Lesokhin, AM; Dai, A; Clurman, A; Slingerland, JB; Slingerland, AE; Brereton, DG; Giardina, PA; Maloy, M; Armijo, GK; Rondon-Clavo, C; Fontana, E; Bohannon, L; Ramalingam, S; Bush, AT; Lew, MV; Messina, JA; Littmann, E; Taur, Y; Jenq, RR; Chao, NJ; Giralt, S; Markey, KA; Pamer, EG; van den Brink, MRM; Peled, JU

Published Date

  • March 18, 2021

Published In

Volume / Issue

  • 137 / 11

Start / End Page

  • 1527 - 1537

PubMed ID

  • 33512409

Pubmed Central ID

  • PMC7976512

Electronic International Standard Serial Number (EISSN)

  • 1528-0020

Digital Object Identifier (DOI)

  • 10.1182/blood.2020006923


  • eng

Conference Location

  • United States