Gut dysbiosis during antileukemia chemotherapy versus allogeneic hematopoietic cell transplantation

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29 Scopus citations


Background: In the field of malignant hematology, most microbiome studies have focused on recipients of allogeneic hematopoietic cell transplantation (allo-HCT). As a result, this population has remained the primary target for novel microbiota therapeutics. Because the types of insults to the microbiome are similar during hematopoietic cell transplantation and intensive antileukemia therapy, this study evaluated whether the dysbiosis states are similar in the 2 settings. Methods: This study compared gut microbiota assemblages and community domination states in 2 cohorts of patients: patients with intensively treated acute leukemia (AL) and allo-HCT recipients. 16S ribosomal RNA gene profiling of thrice weekly stool samples was performed. Linear discriminant analysis effect size was used to determine differentially abundant taxa in groups of interest, and mixed modes were used to determine the predictors of microbiome states. Results: Microbiome changes in both cohorts were characterized by a marked loss of diversity and domination of low-diversity communities by Enterococcus. In the AL cohort, the relative abundance of Lactobacillus was also inversely correlated with diversity. Communities dominated by these genera were compositionally different. Conclusions: Similarities in microbiota assemblages between the 2 cohorts support a broader scope for microbiota-directed therapeutics than previously considered, whereas specific differences suggest a personalized aspect to such therapeutics with the possibility of a differential response.

Original languageEnglish (US)
Pages (from-to)1434-1447
Number of pages14
Issue number7
StatePublished - Apr 1 2020

Bibliographical note

Funding Information:
Armin Rashidi was supported by grants from the University of Minnesota (Medical School Innovation Award and Foundation Grant for New Faculty) and by a Marrow on the Move grant from the Division of Hematology, Oncology, and Transplantation. Thomas Kaiser received partial support from a Masonic Cancer Center Chainbreaker grant (University of Minnesota). In addition, funding from Achieving Cures Together and the Hubbard Broadcasting Foundation supported this research, and Gary M. Dunny reports grants from the National Institutes of Health during the conduct of the study.

Publisher Copyright:
© 2019 American Cancer Society

Copyright 2020 Elsevier B.V., All rights reserved.


  • dysbiosis
  • leukemia
  • microbiota
  • transplantation

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't


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