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Changes in intestinal microbiota and their effects on allogeneic stem cell transplantation
Author(s) -
Shallis Rory M.,
Terry Christopher M.,
Lim Seah H.
Publication year - 2018
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.24896
Subject(s) - dysbiosis , stem cell , microbiome , immunology , hematopoietic stem cell transplantation , hematopoietic stem cell , transplantation , disease , gut flora , biology , intestinal microbiome , immune system , clostridium difficile , graft versus host disease , fecal bacteriotherapy , haematopoiesis , medicine , bioinformatics , microbiology and biotechnology , antibiotics , genetics
The human intestinal microbiota is essential for microbial homeostasis, regulation of metabolism, and intestinal immune tolerance. Rapidly evolving understanding of the importance of the microbiota implicates changes in the composition and function of intestinal microbial communities in an assortment of systemic conditions. Complications following allogeneic stem cell transplant now join the ever‐expanding list of pathologic states regulated by intestinal microbiota. Dysbiosis, or disruption of the normal ecology of this microbiome, has been directly implicated in the pathogenesis of entities such as Clostridium difficile infections, graft‐versus‐host disease (GVHD), and most recently disease relapse, all of which are major causes of morbidity and mortality in patients undergoing allogeneic stem cell transplant. In this review, we elucidate the key origins of microbiotic alterations and discuss how dysbiosis influences complications following allogeneic stem cell transplant. Our emerging understanding of the importance of a balanced and diverse intestinal microbiota is prompting investigation into the appropriate treatment of dysbiosis, reliable and early detection of such, and ultimately its prevention in patients to improve the outcome following allogeneic hematopoietic stem cell transplant.