Guo Zhi, He Mingxin, Shao Liang, Li Yue, Xiang Xiaochen, Wang Qiang
Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan, China.
Department of Hematology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China.
J Cancer Res Ther. 2024 Dec 1;20(7):1964-1973. doi: 10.4103/jcrt.jcrt_33_24. Epub 2025 Jan 10.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is one of the most important methods for treating a wide range of hematologic malignancies and bone marrow failure diseases. However, graft-versus-host disease (GVHD), a major complication associated with this method, can seriously affect the survival and quality of life of patients. Acute GVHD (aGVHD) occurs within 100 days after transplantation, and gastrointestinal aGVHD (GI-aGVHD) is one of the leading causes of nonrecurrent death after allo-HSCT. In recent years, fecal microbiota transplantation (FMT) has been attempted as an emerging treatment method for various diseases, including aGVHD after HSCT. Studies have shown encouraging preliminary clinical results after the application of FMT in aGVHD, particularly steroid-resistant aGVHD. Additionally, several studies have demonstrated that the gut microbiota plays an important immunomodulatory role in the pathogenesis of GVHD. Consensus guidelines recommend FMT as a secondary option for the treatment of aGVHD. This article aims to review FMT treatment for GI-aGVHD after allo-HSCT.
异基因造血干细胞移植（allo-HSCT）是治疗多种血液系统恶性肿瘤和骨髓衰竭性疾病的最重要方法之一。然而，移植物抗宿主病（GVHD）作为该方法的一种主要并发症，会严重影响患者的生存率和生活质量。急性GVHD（aGVHD）发生在移植后100天内，胃肠道aGVHD（GI-aGVHD）是allo-HSCT后非复发死亡的主要原因之一。近年来，粪便微生物群移植（FMT）已被尝试作为包括HSCT后aGVHD在内的各种疾病的一种新兴治疗方法。研究表明，FMT应用于aGVHD，尤其是激素抵抗性aGVHD后，取得了令人鼓舞的初步临床结果。此外，多项研究表明，肠道微生物群在GVHD的发病机制中发挥着重要的免疫调节作用。共识指南推荐FMT作为aGVHD治疗的二线选择。本文旨在综述allo-HSCT后GI-aGVHD的FMT治疗。
