Gut microbes in pediatric ALL survivorship

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer and has a 5 year survival rate of greater than 90%. Despite this extraordinary success, survivors face lifelong chronic health problems including a predisposition to obesity, metabolic syndrome, and resulting complications like cardiovascular disease. In this issue, Thomas et al. (Yang laboratory) investigated the gut microbiome in pediatric ALL survivors and healthy sibling controls. They identified key changes in operational taxonomic units (OTUs), which have been linked previously to obesity and metabolic syndrome. This study suggests that dysbiosis, which can predispose to life-long secondary complications of ALL, begins in childhood immediately after treatment and opens an ample window for interventions aimed at reducing obesity and metabolic syndrome in ALL survivors.