Arjmand Babak, Badamchizadeh Sana, Mehran Pouya, Sarvari Maedeh, Alavi-Moghadam Sepideh, Arjmand Rasta, Rezaei-Tavirani Mostafa, Janbabaei Ghasem, Vaezi Mohamad, Larijani Bagher
Hematology-Oncology and Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology, and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran.
Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Stem Cell Rev Rep. 2025 Nov;21(8):2529-2547. doi: 10.1007/s12015-025-10958-w. Epub 2025 Sep 4.
Hematopoietic stem cell transplantation is an important treatment for hematological malignancy and disorders, but is fraught with high risks, including graft-versus-host disease, infection, and relapse. Recent evidence now identifies that the microbiome plays a significant role in influencing transplant outcomes, in which microbial dysbiosis-defined by reduced diversity and pathogen overgrowth-is linked to greater complications and death. Microbiome manipulation with approaches including beneficial microbial species, fiber, fecal transplants, and diet has the potential to mitigate these risks. Experiments show that the restoration of beneficial microbes can restore immunity, reduce graft-versus-host disease severity, and reduce infection. Some challenges remain, including standardization of protocols, long-term efficacy, and safety in immunocompromised recipients. Future research will be focused on mechanisms, trials, and new technology for microbiome-based therapy, with the ultimate goal of improving survival and quality of life for transplant recipients. Hereupon, this review addresses how microbiome engineering can revolutionize cancer treatment by optimizing gut microbial communities for better outcomes in hematopoietic stem cell transplantation (HSCT).
造血干细胞移植是治疗血液系统恶性肿瘤和疾病的重要方法，但充满了高风险，包括移植物抗宿主病、感染和复发。最近的证据表明，微生物群在影响移植结果方面起着重要作用，其中微生物失调（以多样性降低和病原体过度生长为特征）与更多并发症和死亡相关。采用包括有益微生物种类、纤维、粪便移植和饮食等方法对微生物群进行调控，有可能降低这些风险。实验表明，恢复有益微生物可恢复免疫力、减轻移植物抗宿主病的严重程度并减少感染。仍存在一些挑战，包括方案的标准化、长期疗效以及免疫受损受者的安全性。未来的研究将集中在基于微生物群治疗的机制、试验和新技术上，最终目标是提高移植受者的生存率和生活质量。因此，本综述探讨了微生物群工程如何通过优化肠道微生物群落，在造血干细胞移植（HSCT）中实现更好的治疗效果，从而彻底改变癌症治疗。
