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Lasting shift in the gut microbiota in patients with acute myeloid leukemia

Armin Rashidi1, Maryam Ebadi1, Tauseef Ur Rehman1

  • 1Division of Hematology, Oncology, and Transplantation, Department of Medicine.

Blood Advances
|February 22, 2022
PubMed

Insights

Acute myeloid leukemia (AML) chemotherapy severely disrupts the gut microbiota, causing lasting changes. These altered gut microbial communities persist long-term, impacting patient outcomes and treatment strategies.

Area of Science:

  • Microbiology
  • Oncology
  • Gastroenterology

Background:

  • Gut microbiota dysbiosis is observed in acute myeloid leukemia (AML) patients during chemotherapy.
  • The long-term impact and durability of these microbiota alterations remain largely unknown.
  • Reduced gut microbiota diversity post-chemotherapy is linked to increased mortality in stem cell transplantation.

Purpose of the Study:

  • To investigate the durability and long-term effects of gut microbiota changes in patients with AML undergoing induction chemotherapy.
  • To understand the recovery trajectory of the gut microbiota after hospital discharge and reduced antibiotic pressure.

Main Methods:

  • Longitudinal sequencing of gut microbiota from 410 stool samples collected from 52 AML patients.
  • Analysis of microbiota composition and diversity during and after inpatient chemotherapy.

Main Results:

  • Gut microbiota in AML patients is significantly stressed and unable to recover its original state during inpatient chemotherapy.
  • Post-discharge, despite reduced disturbances, the microbiota recovers into new communities dissimilar to the patient's baseline.
  • This lasting dysbiosis indicates a persistent alteration in gut microbial ecology.

Conclusions:

  • Induction chemotherapy causes durable and profound gut microbiota alterations in AML patients.
  • The persistent shift in gut microbiota composition has implications for subsequent cancer therapy phases.
  • Targeting these lasting microbiota changes may offer novel therapeutic interventions for AML patients.

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