Microbiome dysbiosis and chemotherapy resistance in acute myeloid leukemia (AML)

AML often relapses due to chemotherapy resistance, increasingly linked to gut microbiome dysbiosis. Microbial drug modification, immune modulation, and metabolite-driven survival/epigenetic changes (e.g., SCFAs, kynurenine) promote resistance. Clinical data associate reduced diversity, loss of Faecalibacterium, and Enterococcus overgrowth with poorer outcomes. Microbiome interventions (FMT, probiotics, diet) show promise; priorities are standardizing methods and defining microbe-metabolite mechanisms to guide trials.