Salvestrini Valentina, Conti Gabriele, D'Amico Federica, Cristiano Gianluca, Candela Marco, Cavo Michele, Turroni Silvia, Curti Antonio
Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Human Microbiomics Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Cancer Med. 2025 Feb;14(3):e70501. doi: 10.1002/cam4.70501.
The management of acute myeloid leukemia (AML) is hindered by treatment-related toxicities and complications, particularly cytopenia, which remains a leading cause of mortality. Given the pivotal role of the gut microbiota (GM) in hemopoiesis and immune regulation, we investigated its impact on hematologic recovery during AML induction therapy.
We profiled the GM of 27 newly diagnosed adult AML patients using 16S rRNA amplicon sequencing and correlated it with key clinical parameters before and after induction therapy.
Our investigation revealed intriguing associations between the GM composition and crucial recovery indicators, including platelet, lymphocyte, and neutrophil counts, and identified early GM signatures predictive of improved hematologic recovery. Remarkably, patients demonstrating superior recovery had higher alpha diversity and enrichment in health-associated taxa belonging to the genera Faecalibacterium, Ruminococcus, Blautia, and Butyricimonas at diagnosis.
Despite certain study limitations, our findings suggest that evaluating GM features could serve as a potential marker for hematologic recovery. This preliminary work opens avenues for personalized risk assessment and interventions, possibly involving GM modulation tools, to optimize recovery in AML patients undergoing induction therapy and potentially enhancing overall outcomes in individuals with hematologic diseases.
急性髓系白血病（AML）的治疗受到与治疗相关的毒性和并发症的阻碍，尤其是血细胞减少，它仍然是主要的死亡原因。鉴于肠道微生物群（GM）在造血和免疫调节中的关键作用，我们研究了其对AML诱导治疗期间血液学恢复的影响。
我们使用16S rRNA扩增子测序对27例新诊断的成年AML患者的GM进行了分析，并将其与诱导治疗前后的关键临床参数进行了关联。
我们的研究揭示了GM组成与关键恢复指标之间有趣的关联，包括血小板、淋巴细胞和中性粒细胞计数，并确定了预测血液学恢复改善的早期GM特征。值得注意的是，在诊断时，显示出较好恢复的患者具有更高的α多样性，并且在属于粪杆菌属、瘤胃球菌属、布劳特氏菌属和丁酸单胞菌属的与健康相关的分类群中更为丰富。
尽管本研究存在一定局限性，但我们的发现表明，评估GM特征可能作为血液学恢复的潜在标志物。这项初步工作为个性化风险评估和干预开辟了途径，可能涉及GM调节工具，以优化接受诱导治疗的AML患者的恢复，并可能改善血液病患者的总体结局。
