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Title

Fecal microbiota transplantation before or after allogeneic hematopoietic transplantation in patients with hematologic malignancies carrying multidrug-resistance bacteria

Authors
Battipaglia, Giorgia
Malard, Florent
Rubio, Marie Therèse
Ruggeri, Annalisa
Mamez, Anne Claire
Brissot, Eolia
Dulery, Remy
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Published in Haematologica. 2019, vol. 104, no. 8, p. 1682-1688
Abstract Fecal microbiota transplantation is an effective treatment in recurrent Clostridium difficile infection. Promising results to eradicate multidrug-resistant bacteria have also been reported with this procedure, but there are safety concerns in immunocompromised patients. We report results in ten adult patients colonized with multidrug-resistant bacteria, undergoing fecal microbiota transplantation before (n=4) or after (n=6) allogeneic hematopoietic stem cell transplantation for hematologic malignancies. were obtained from healthy related or unrelated donors. Fecal material was delivered either by enema or via nasogastric tube. Patients were colonized or had infections from either carbapenemase-producing bacteria (n=8) or vancomycin-resistant enterococci (n=2). Median age at fecal microbiota transplantation was 48 (range, 16-64) years. Three patients needed a second transplant from the same donor due to initial failure of the procedure. With a median follow up of 13 (range, 4-40) months, decolonization was achieved in seven of ten patients. In all patients, fecal micro-biota transplantation was safe: one patient presented with constipation during the first five days after FMT and two patients had grade I diarrhea. One case of gut grade III acute graft-versus-host disease occurred after fecal microbiota transplantation. In patients carrying or infected by multidrug-resistant bacteria, fecal microbiota transplantation is an effective and safe decolonization strategy, even in those with hematologic malignancies undergoing hematopoietic stem cell transplantation.
Keywords AdultAgedDrug Resistance, Multiple, BacterialDysbiosis/etiology/therapyFecal Microbiota Transplantation/methodsFemaleHematologic Neoplasms/complications/diagnosis/therapyHematopoietic Stem Cell TransplantationHumansMaleMiddle AgedPerioperative Care/methodsRetrospective StudiesTransplantation, HomologousTreatment Outcome
Identifiers
PMID: 30733264
Full text
Research group Leucémie et transplantation allogénique de cellules souches hématopoïétiques (982)
Citation
(ISO format)
BATTIPAGLIA, Giorgia et al. Fecal microbiota transplantation before or after allogeneic hematopoietic transplantation in patients with hematologic malignancies carrying multidrug-resistance bacteria. In: Haematologica, 2019, vol. 104, n° 8, p. 1682-1688. doi: 10.3324/haematol.2018.198549 https://archive-ouverte.unige.ch/unige:143940

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Deposited on : 2020-11-02

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