The association between the incidence of intestinal graft‐vs‐host disease and antibiotic use after allogeneic hematopoietic stem cell transplantation
Abstract
Intestinal microbiota plays an important role in the regulation of allogeneic immune reaction after allogeneic hematopoietic stem cell transplantation (allo‐SCT). Intestinal graft‐vs‐host disease (GVHD) is one of the major causes of mortality after allo‐SCT and often complicated with intestinal dysbiosis. Recent studies suggest that antibiotic‐induced dysbiosis is a risk factor for intestinal GVHD. We retrospectively evaluated the impacts of antibiotic use on the incidence of intestinal GVHD occurring before day 100 after allo‐SCT. Among 213 patients who underwent allo‐SCT, 200 patients achieving engraftment were analyzed. Antibiotics were classified into carbapenem, quinolone, penicillin, cephem, and glycopeptide. Among 128 patients who developed acute GVHD, intestinal GVHD developed in 36 patients. Patients with intestinal GVHD received significantly longer administration of carbapenem and glycopeptide compared to those without it in periengraftment period. In multivariate analysis, use of carbapenem for greater than 7 days was associated with an increased risk of intestinal GVHD. However, use of antibiotics for greater than 7 days was not associated with poor overall survival and high nonrelapse mortality. Long use of carbapenem in periengraftment period may be a risk for intestinal GVHD. Prospective studies are required to validate our findings.
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Single-center studies have linked post-HCT intestinal microbiota features to relapse, GVHD, infection, organ toxicity, and overall survival.
“Each of these outcomes, as well as overall survival, has been associated in single-center studies with features of the intestinal microbiota in the period after hematopoietic-cell transplantation.2–4,8–15”
From Microbiota as Predictor of Mortality in Allogeneic Hematopoietic-Cell Transplantation (2020) · cites this paper as [11]
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- Authors
- Hidaka, D., Hayase, E., Shiratori, S., Hasegawa, Y., Ishio, T., Tateno, T., Okada, K., Goto, H., Sugita, J., Onozawa, M., Nakagawa, M., Kahata, K., Endo, T., Hashimoto, D., & Teshima, T.
- Affiliations
- Hokkaido University (JP)
- Corresponding author
- Hayase, Eiko
- ORCID
- Venue
- Clinical Transplantation
- Publisher
- Wiley
- Published
- 2018-08-13
- Volume
- 32
- Issue
- 9
- Pages
- e13361-e13361
- ISSN
- 0902-0063 (ISSN-L)
- 1399-0012
- OpenAlex
- W2884254533
- Cited by
- 39
- References
- 26
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 4 · 2023: 11 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 1
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Transplantation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (17H04206, 17K19641, 17K09945, 18K08313)
- Topics
- Health Sciences › Medicine › Hematology › Hematopoietic Stem Cell Transplantation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
- Keywords
- gastrointestinal graft-versus-host disease, allogeneic hematopoietic stem cell transplantation, antibiotic use, carbapenems, gut dysbiosis, gut microbiota, overall survival, non-relapse mortality
- MeSH terms
- Gastrointestinal Microbiome, Adolescent, Adult, Aged, Anti-Bacterial Agents, Female, Follow-Up Studies, Graft vs Host Disease, Humans, Intestinal Diseases, Japan, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Factors, Hematopoietic Stem Cell Transplantation, Hematologic Neoplasms, Young Adult
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