Han Lijie, Zhang Haiyan, Ma Ping, Peng Jie, Li Yilu, Wu Jiaying, Li Yuanyuan, Yu Jifeng, Li Wei, Zhang Mengmeng, He Jia Bao, Fan Zhiping, Wang Weimin, Sang Li'na, Sun Hui, Liu Qifa, Liu Yang, Jiang Zhongxing
Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Ann Hematol. 2022 Jun;101(6):1283-1294. doi: 10.1007/s00277-022-04817-8. Epub 2022 Mar 25.
Intestinal microbiota is an important prognostic factor for allogeneic hematopoietic stem cell transplantation (allo-HSCT), but its role in predicting survival has not been determined. Here, stool samples at day 15 ± 1 posttransplant were obtained from 209 patients at two centers. Microbiota was examined using 16S rRNA sequencing. The microbiota diversity and abundance of specific bacteria (including Lachnospiraceae, Ruminococcaceae, Erysipelotrichaceae, and Enterobacteriaceae) were assigned a value of 0 or 1 depending on whether they were positive or negative associated with survival, respectively. An accumulated intestinal microbiota (AIM) score was generated, and patients were divided into low- and high-score groups. A low score was associated with a better 3-year cumulative overall survival (OS) as well as lower mortality than a high score (88.5 vs. 43.9% and 7.1 vs. 35.8%, respectively; both P < 0.001). In multivariate analysis, a high score was found to be an independent risk factor for OS and transplant-related mortality (hazard ratio = 5.68 and 3.92, respectively; P < 0.001 and 0.003, respectively). Furthermore, the AIM score could serve as a predictor for survival (area under receiver operating characteristic curve = 0.836, P < 0.001). Therefore, the intestinal microbiota score at neutrophil recovery could predict survival following allo-HSCT.
肠道微生物群是异基因造血干细胞移植(allo-HSCT)的一个重要预后因素,但其在预测生存方面的作用尚未确定。在此,从两个中心的209例患者中获取了移植后15±1天的粪便样本。使用16S rRNA测序检测微生物群。特定细菌(包括毛螺菌科、瘤胃球菌科、丹毒丝菌科和肠杆菌科)的微生物群多样性和丰度根据它们与生存的正相关或负相关分别赋值为0或1。生成了累积肠道微生物群(AIM)评分,并将患者分为低分和高分两组。低分与3年累积总生存率(OS)较好以及死亡率低于高分相关(分别为88.5%对43.9%和7.1%对35.8%;P均<0.001)。在多变量分析中,高分被发现是OS和移植相关死亡率的独立危险因素(风险比分别为5.68和3.92;P分别<0.001和0.003)。此外,AIM评分可作为生存的预测指标(受试者工作特征曲线下面积=0.836,P<0.001)。因此,中性粒细胞恢复时的肠道微生物群评分可预测allo-HSCT后的生存情况。