Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box 9, New York, NY, 10065, USA.
, Palisades Park, USA.
Dig Dis Sci. 2022 Jun;67(6):2503-2509. doi: 10.1007/s10620-021-07024-z. Epub 2021 Jun 4.
Recurrent Clostridiodies difficile infection (CDI) contributes to morbidity and mortality in cancer patients. Fecal microbiota transplantation (FMT) has been proven to be effective in treatment of recurrent CDI, but immunocompromised patients have been excluded from prospective studies due to safety concerns. The aim of this study was to investigate the safety of FMT for recurrent CDI in immunocompromised patients with solid tumor malignancy undergoing chemotherapy.
This was a single center, prospective observational study of patients at a tertiary care cancer center of 10 patients with recurrent CDI who were at least 18 years of age, with a solid tumor malignancy who had received chemotherapy within the previous 6 months. Patients received FMT either by upper endoscopy or colonoscopy and were followed for 6 months. Safety was a primary outcome measured by infections occurring within 2 weeks of FMT. Efficacy of FMT was also evaluated.
Nineteen patients were evaluated. On applying exclusion criteria, 10 were included in the study. One patient requested to be off study within 2 weeks and was considered a treatment failure. Seven received FMT via upper endoscopy, three via colonoscopy. There were no infectious complications from FMT. Eight patients (80%) were cured after the first FMT. All eight patients went on to restart oncologic treatment with an average of 32.5 days after FMT.
FMT is safe and effective for recurrent CDI in solid tumor patients undergoing chemotherapy. Patients can resume oncologic treatment after FMT.
复发性艰难梭菌感染（CDI）会增加癌症患者的发病率和死亡率。粪便微生物群移植（FMT）已被证明对复发性 CDI 有效，但由于安全性问题，免疫功能低下的患者被排除在前瞻性研究之外。本研究旨在调查 FMT 治疗接受化疗的实体瘤恶性肿瘤免疫功能低下患者复发性 CDI 的安全性。
这是一项在一家三级癌症中心进行的单中心前瞻性观察性研究，纳入了 10 名至少 18 岁、患有实体瘤恶性肿瘤且在过去 6 个月内接受过化疗的复发性 CDI 患者。患者接受 FMT 治疗，方法为上内窥镜或结肠镜检查，并随访 6 个月。安全性是通过 FMT 后 2 周内发生的感染来衡量的主要结局。还评估了 FMT 的疗效。
评估了 19 名患者，应用排除标准后，10 名患者纳入研究。1 名患者在 2 周内要求退出研究，被认为是治疗失败。7 名患者通过上内窥镜接受 FMT，3 名患者通过结肠镜接受 FMT。FMT 无感染并发症。第一次 FMT 后，有 8 名患者（80%）治愈。所有 8 名患者在 FMT 后平均 32.5 天重新开始肿瘤治疗。
FMT 治疗接受化疗的实体瘤患者复发性 CDI 是安全有效的。患者可以在 FMT 后恢复肿瘤治疗。
