Impact of gut fungal and bacterial communities on the outcome of allogeneic hematopoietic cell transplantation

Mucosal Immunol. 2021 Sep;14(5):1127-1132. doi: 10.1038/s41385-021-00429-z. Epub 2021 Jul 19.

Abstract

Patients receiving allogeneic hematopoietic cell transplantation (alloHCT) were previously shown to display a bacterial gut dysbiosis; however, limited data are available regarding the role of fungal microbiota in these patients. We evaluated the bacterial and fungal composition of the fecal microbiota at day 0 of alloHCT. Higher bacterial diversity was associated with an improved overall survival (OS) and disease-free survival (DFS). While fungal diversity had no impact on patient outcomes, we observed that high versus low relative abundance of Candida albicans in alloHCT patients at day 0 was associated with a significantly lower OS, DFS and graft-versus-host-free, relapse-free survival (GRFS) (p = 0.0008, p = 0.0064 and p = 0.026, respectively). While these results are limited by low patient numbers and low fungal read counts in some samples, they suggest a potentially important role for C albicans in alloHCT.

MeSH terms

  • Adult
  • Aged
  • Female
  • Gastrointestinal Microbiome*
  • Graft vs Host Disease / diagnosis
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / prevention & control
  • Health Impact Assessment*
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / methods
  • Histocompatibility
  • Humans
  • Male
  • Metagenome
  • Metagenomics
  • Microbial Consortia*
  • Middle Aged
  • Mycobiome*
  • Prognosis
  • Proportional Hazards Models
  • Transplantation Conditioning
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult