title: The intestinal microbiota in allogeneic hematopoietic cell transplant and graft-versus-host disease.
abstract: Hematopoietic cell transplantation (HCT) is a critical treatment of patients with high-risk hematopoietic malignancies, hematological deficiencies, and other immune diseases. In allogeneic HCT (allo-HCT), donor-derived T cells recognize host tissues as foreign, causing graft-versus-host disease (GVHD) which is a main contributor to morbidity and mortality. The intestine is one of the organs most severely affected by GVHD and research has recently highlighted the importance of bacteria, particularly the gut microbiota, in HCT outcome and in GVHD development. Loss of intestinal bacterial diversity is common during the course of HCT and is associated with GVHD development and treatment with broad-spectrum antibiotics. Loss of intestinal diversity and outgrowth of opportunistic pathogens belonging to the phylum Proteobacteria andEnterococcusgenus have also been linked to increased treatment-related mortality including GVHD, infections, and organ failure after allo-HCT. Experimental studies in allo-HCT animal models have shown some promising results for prebiotic and probiotic strategies as prophylaxis or treatment of GVHD. Continuous research will be important to define the relation of cause and effect for these associations between microbiota features and HCT outcomes. Importantly, studies focused on geographic and cultural differences in intestinal microbiota are necessary to define applicability of new strategies targeting the intestinal microbiota.
authors.affiliation: Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Anna
authors.identifier: 0000-0001-8373-7312
authors.initials: A
authors.lastname: Staffas
authors.affiliation: Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Marina
authors.identifier: 0000-0001-8630-7211
authors.initials: M
authors.lastname: Burgos da Silva
authors.affiliation: Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY.|Department of Medicine and.|Department of Immunology, Weill Medical College of Cornell University, New York, NY; and.|Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Marcel R M
authors.identifier: 0000-0003-0696-4401
authors.initials: MR
authors.lastname: van den Brink
mesh_terms: D000818:Animals; D000069196:Gastrointestinal Microbiome; D006086:Graft vs Host Disease / Q000150:complications / Q000382:microbiology* / Q000503:physiopathology / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007422:Intestines / Q000382:microbiology* / Q000503:physiopathology; D009752:Nutritional Status; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous