Abstract
Intestinal microbiota (IM) diversity and composition regulates host immunity and affects outcomes after allogeneic stem cell transplantation (allo-HSCT). We evaluated if the oral mucosa microbiota (OM) could impact the outcomes in patients who underwent allo-HSCT. Samples from the oral mucosa of 30 patients were collected at three time points: before the conditioning regimen, at aplasia, and at engraftment. We analyzed the associations of OM diversity and composition with allo-HSCT outcomes. Lower OM diversity at preconditioning was associated with a higher risk of relapse at 3 years (68% versus 33%, respectively; P = 0.04). Dominance (relative abundance ≥ 30%) by a single genus at preconditioning was also associated with a higher risk of relapse (63% versus 36% at 3 years, respectively; P = 0.04), as well as worse progression-free survival (PFS; 19% versus 55%, respectively; P = 0.01), and overall survival (OS) at 3 years (38% versus 81%, respectively; P = 0.02). In our study we observed that OM dysbiosis is associated with a higher risk of relapse and worse survival after allo-HSCT.
Highlights
Intestinal microbiota (IM) diversity and composition regulates host immunity and affects outcomes after allogeneic stem cell transplantation
To the best of our knowledge, this is the first study to evaluate the possible impact of the oral mucosa microbiota (OM) using amplicon sequencing variants (ASVs) on allo-HSCT outcomes
ASVs, which are read sequences denoised to single-nucleotide resolution, is a more reproducible and comprehensive technique with higher sensitivity and specificity than operational taxonomic units (OTU) in analyzing microbiota[44,45,46]
Summary
Intestinal microbiota (IM) diversity and composition regulates host immunity and affects outcomes after allogeneic stem cell transplantation (allo-HSCT). We evaluated if the oral mucosa microbiota (OM) could impact the outcomes in patients who underwent allo-HSCT. We analyzed the associations of OM diversity and composition with allo-HSCT outcomes. In our study we observed that OM dysbiosis is associated with a higher risk of relapse and worse survival after allo-HSCT. Abbreviations 95% Cis Ninety-five percent confidence intervals aGVHD Acute GVHD allo-HSCT Allogeneic stem cell transplantation ASVs Amplicon sequencing variants cGVHD Chronic GVHD DRI Disease risk index GVHD Graft versus host disease IM Intestinal microbiota NRM Non-relapse mortality OM Oral mucosa microbiota OS Overall survival PFS Progression-free survival. IM disruption, characterized by significant changes in microbiota diversity and composition, is associated with allo-HSCT clinical outcomes. In allo-HSCT, IM disruption is associated with the incidence of G VHD20–22, overall survival (OS)[23,24,25,26], and underlying disease r elapse[27,28]
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