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[Effects of high-dose methotrexate therapy on intestinal bacterial flora in children with acute lymphoblastic

Wu Yang1, Hua Liu, Jing Duan

  • 1Department of Pediatrics, the First Affiliated Hospital, Kunming Medical College, Kunming 650032, China.

Zhonghua Er Ke Za Zhi = Chinese Journal of Pediatrics
|December 23, 2008
PubMed

Insights

High-dose methotrexate (HDMTX) therapy significantly reduces beneficial bacteria like Bacillus bifidus and Escherichia coli in children with acute lymphoblastic leukemia (ALL). Gut flora levels were lowest three days post-treatment but began recovering by day seven.

Area of Science:

  • Microbiology
  • Pediatric Oncology
  • Gastroenterology

Background:

  • Intestinal flora plays a crucial role in maintaining gut health.
  • Chemotherapy, including high-dose methotrexate (HDMTX), can significantly impact the gut microbiome.
  • Understanding these changes is vital for managing side effects in pediatric cancer patients.

Purpose of the Study:

  • To investigate the impact of HDMTX therapy on specific intestinal bacteria, Bacillus bifidus and Escherichia coli, in children with acute lymphoblastic leukemia (ALL).
  • To quantify changes in these bacterial populations before, during, and after HDMTX treatment.

Main Methods:

  • Stool samples were collected from 36 children with ALL (pre- and post-HDMTX) and 36 healthy controls.
  • Bacterial DNA was extracted, and specific primers for Bacillus bifidus and Escherichia coli were used.
  • Quantitative PCR (qPCR) with standard curves was employed to measure the absolute amounts of these bacteria.

Main Results:

  • Children with ALL showed significantly lower levels of Bacillus bifidus and Escherichia coli compared to controls (P < 0.01).
  • HDMTX therapy led to a significant reduction in both Bacillus bifidus and Escherichia coli in ALL patients (P < 0.01).
  • Bacterial levels were lowest on day three post-treatment, with a gradual increase observed by day seven.

Conclusions:

  • HDMTX therapy profoundly affects the intestinal flora, significantly decreasing Bacillus bifidus and Escherichia coli in children with ALL.
  • The study highlights a significant decrease in these beneficial bacteria in the ALL group compared to the control group.
  • Findings suggest potential implications for gut health and the need for strategies to restore microbial balance post-chemotherapy.
Abstract

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