Skip to main content
Erschienen in: Annals of Hematology 9/2017

21.07.2017 | Original Article

Clinical impact of pre-transplant gut microbial diversity on outcomes of allogeneic hematopoietic stem cell transplantation

verfasst von: Noriko Doki, Masahiro Suyama, Satoshi Sasajima, Junko Ota, Aiko Igarashi, Iyo Mimura, Hidetoshi Morita, Yuki Fujioka, Daisuke Sugiyama, Hiroyoshi Nishikawa, Yutaka Shimazu, Wataru Suda, Kozue Takeshita, Koji Atarashi, Masahira Hattori, Eiichi Sato, Kyoko Watakabe-Inamoto, Kosuke Yoshioka, Yuho Najima, Takeshi Kobayashi, Kazuhiko Kakihana, Naoto Takahashi, Hisashi Sakamaki, Kenya Honda, Kazuteru Ohashi

Erschienen in: Annals of Hematology | Ausgabe 9/2017

Einloggen, um Zugang zu erhalten

Abstract

Post-transplant microbial diversity in the gastrointestinal tract is closely associated with clinical outcomes following allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, little is known about the impact of the fecal microbiota before allo-HSCT. We analyzed fecal samples approximately 2 weeks before conditioning among 107 allo-HSCT recipients between 2013 and 2015. Microbial analysis was performed using 16S rRNA gene sequencing. Operational taxonomic unit-based microbial diversity was estimated by calculating the Shannon index. Patients were classified into three groups based on the diversity index: low (<2), intermediate (2, 3), and high (>3) diversity (18 (16.8%), 48 (44.9%), and 41 (38.3%) patients, respectively). There were no significant differences in the 20-month overall survival, cumulative incidence of relapse, and non-relapse mortality among three groups. The cumulative incidence of grade II to IV acute graft-versus-host disease (aGVHD) was similar among the three groups (low 55.6%; intermediate 35.4%; high 48.8%, p = 0.339, at day 100). Furthermore, we found no differences in the cumulative incidence of grade II to IV acute gastrointestinal GVHD among the three groups (low 38.9%; intermediate 21.3%; high 24.4%, p = 0.778, at day 100). Regarding the composition of microbiota before allo-HSCT, aGVHD patients showed a significantly higher abundance of phylum Firmicutes (p < 0.01) and a lower tendency for Bacteroidetes (p = 0.106) than non-aGVHD patients. Maintenance of Bacteroidetes throughout allo-HSCT may be a strategy to prevent aGVHD.
Literatur
1.
2.
Zurück zum Zitat Scher JU, Sczesnak A, Longman RS, Segata N, Ubeda C, Bielski C et al (2013) Expansion of intestinal Prevotella copri correlates with enhanced susceptibility to arthritis. elife 2:e01202CrossRefPubMedPubMedCentral Scher JU, Sczesnak A, Longman RS, Segata N, Ubeda C, Bielski C et al (2013) Expansion of intestinal Prevotella copri correlates with enhanced susceptibility to arthritis. elife 2:e01202CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Ivanov II, Atarashi K, Manel N, Brodie EL, Shima T, Karaoz U et al (2009) Induction of intestinal Th17 cells by segmented filamentous bacteria. Cell 139:485–498CrossRefPubMedPubMedCentral Ivanov II, Atarashi K, Manel N, Brodie EL, Shima T, Karaoz U et al (2009) Induction of intestinal Th17 cells by segmented filamentous bacteria. Cell 139:485–498CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Smith MI, Yatsunenko T, Manary MJ, Trehan I, Mkakosya R, Cheng J et al (2013) Gut microbiomes of Malawian twin pairs discordant for kwashiorkor. Science 339:548–554CrossRefPubMedPubMedCentral Smith MI, Yatsunenko T, Manary MJ, Trehan I, Mkakosya R, Cheng J et al (2013) Gut microbiomes of Malawian twin pairs discordant for kwashiorkor. Science 339:548–554CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Taur Y, Jenq RR, Perales MA, Littmann ER, Morjaria S, Ling L et al (2014) The effects of intestinal tract bacterial diversity on mortality following allogeneic hematopoietic stem cell transplantation. Blood 124:1174–1182CrossRefPubMedPubMedCentral Taur Y, Jenq RR, Perales MA, Littmann ER, Morjaria S, Ling L et al (2014) The effects of intestinal tract bacterial diversity on mortality following allogeneic hematopoietic stem cell transplantation. Blood 124:1174–1182CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Holler E, Butzhammer P, Schmid K, Hundsrucker C, Koestler J, Peter K et al (2014) Metagenomic analysis of the stool microbiome in patients receiving allogeneic stem cell transplantation: loss of diversity is associated with use of systemic antibiotics and more pronounced in gastrointestinal graft-versus-host disease. Biol Blood Marrow Transplant 20:640–645CrossRefPubMedPubMedCentral Holler E, Butzhammer P, Schmid K, Hundsrucker C, Koestler J, Peter K et al (2014) Metagenomic analysis of the stool microbiome in patients receiving allogeneic stem cell transplantation: loss of diversity is associated with use of systemic antibiotics and more pronounced in gastrointestinal graft-versus-host disease. Biol Blood Marrow Transplant 20:640–645CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Jenq RR, Taur Y, Devlin SM, Ponce DM, Goldberg JD, Ahr KF et al (2015) Intestinal blautia is associated with reduced death from graft-versus-host disease. Biol Blood Marrow Transplant 21:1373–1383CrossRefPubMedPubMedCentral Jenq RR, Taur Y, Devlin SM, Ponce DM, Goldberg JD, Ahr KF et al (2015) Intestinal blautia is associated with reduced death from graft-versus-host disease. Biol Blood Marrow Transplant 21:1373–1383CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Mori J, Ohashi K, Yamaguchi T, Ando M, Hirashima Y, Kobayashi T et al (2012) Risk assessment for acute kidney injury after allogeneic hematopoietic stem cell transplantation based on Acute Kidney Injury Network criteria. Intern Med 51:2105–2110CrossRefPubMed Mori J, Ohashi K, Yamaguchi T, Ando M, Hirashima Y, Kobayashi T et al (2012) Risk assessment for acute kidney injury after allogeneic hematopoietic stem cell transplantation based on Acute Kidney Injury Network criteria. Intern Med 51:2105–2110CrossRefPubMed
9.
Zurück zum Zitat Rowlings PA, Przepiorka D, Klein JP, Gale RP, Passweg JR, Henslee-Downey PJ et al (1997) IBMTR Severity Index for grading acute graft-versus-host disease: retrospective comparison with Glucksberg grade. Br J Haematol 97:855–864CrossRefPubMed Rowlings PA, Przepiorka D, Klein JP, Gale RP, Passweg JR, Henslee-Downey PJ et al (1997) IBMTR Severity Index for grading acute graft-versus-host disease: retrospective comparison with Glucksberg grade. Br J Haematol 97:855–864CrossRefPubMed
10.
Zurück zum Zitat Vigorito AC, Campregher PV, Storer BE, Carpenter PA, Moravec CK, Kiem HP et al (2009) Evaluation of NIH consensus criteria for classification of late acute and chronic GVHD. Blood 114:702–708CrossRefPubMedPubMedCentral Vigorito AC, Campregher PV, Storer BE, Carpenter PA, Moravec CK, Kiem HP et al (2009) Evaluation of NIH consensus criteria for classification of late acute and chronic GVHD. Blood 114:702–708CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Tsuda A, Suda W, Morita H, Takahashi K, Takagi A, Koga Y et al (2015) Influence of proton-pump inhibitors on the luminal microbiota in the gastrointestinal tract. Clin Transl Gastroenterol 6:e89CrossRefPubMedPubMedCentral Tsuda A, Suda W, Morita H, Takahashi K, Takagi A, Koga Y et al (2015) Influence of proton-pump inhibitors on the luminal microbiota in the gastrointestinal tract. Clin Transl Gastroenterol 6:e89CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG et al (2005) Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood 106:2912–2919CrossRefPubMedPubMedCentral Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG et al (2005) Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood 106:2912–2919CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Weber D, Oefner PJ, Hiergeist A, Koestler J, Gessner A, Weber M et al (2015) Low urinary indoxyl sulfate levels early after transplantation reflect a disrupted microbiome and are associated with poor outcome. Blood 126:1723–1728CrossRefPubMed Weber D, Oefner PJ, Hiergeist A, Koestler J, Gessner A, Weber M et al (2015) Low urinary indoxyl sulfate levels early after transplantation reflect a disrupted microbiome and are associated with poor outcome. Blood 126:1723–1728CrossRefPubMed
14.
Zurück zum Zitat Biagi E, Zama D, Nastasi C, Consolandi C, Fiori J, Rampelli S et al (2015) Gut microbiota trajectory in pediatric patients undergoing hematopoietic SCT. Bone Marrow Transplant 50:992–998CrossRefPubMed Biagi E, Zama D, Nastasi C, Consolandi C, Fiori J, Rampelli S et al (2015) Gut microbiota trajectory in pediatric patients undergoing hematopoietic SCT. Bone Marrow Transplant 50:992–998CrossRefPubMed
15.
Zurück zum Zitat Chiusolo P, Metafuni E, Sterbini FP, Giammarco S, Masucci L, Leone G et al (2015) Gut microbiome changes after stem cell transplantation. Blood 126:1953 Chiusolo P, Metafuni E, Sterbini FP, Giammarco S, Masucci L, Leone G et al (2015) Gut microbiome changes after stem cell transplantation. Blood 126:1953
Metadaten
Titel
Clinical impact of pre-transplant gut microbial diversity on outcomes of allogeneic hematopoietic stem cell transplantation
verfasst von
Noriko Doki
Masahiro Suyama
Satoshi Sasajima
Junko Ota
Aiko Igarashi
Iyo Mimura
Hidetoshi Morita
Yuki Fujioka
Daisuke Sugiyama
Hiroyoshi Nishikawa
Yutaka Shimazu
Wataru Suda
Kozue Takeshita
Koji Atarashi
Masahira Hattori
Eiichi Sato
Kyoko Watakabe-Inamoto
Kosuke Yoshioka
Yuho Najima
Takeshi Kobayashi
Kazuhiko Kakihana
Naoto Takahashi
Hisashi Sakamaki
Kenya Honda
Kazuteru Ohashi
Publikationsdatum
21.07.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Annals of Hematology / Ausgabe 9/2017
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-017-3069-8

Weitere Artikel der Ausgabe 9/2017

Annals of Hematology 9/2017 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.