Acute graft-versus-host disease (aGvHD) reduces the efficiency and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT). In recent years, attempts have been made to transplant fecal microbiota from healthy donors to treat intestinal GvHD. This study presented two cases of patients undergoing allo-HSCT who were later selected for fecal microbiota transplantation (FMT). In the first patient, FMT resulted in the complete resolution of symptoms, whereas therapeutic efficacy was not achieved in the second patient. FMT eliminated drug-resistant pathogens, namely very drug-resistant Enterococcus spp., but not multidrug-resistant Acinetobacter baumannii or Candida spp. Further research is needed, particularly on the safety of FMT in patients with intestinal steroid-resistant GvHD and on the distant impact of transplanted microflora on the outcomes of allo-HSCT. FMT appears promising for the treatment of patients with steroid-resistant GvHD.

译文

急性移植物抗宿主病 (aGvHD) 降低异基因造血干细胞移植 (allo-HSCT) 的效率和安全性。近年来,人们尝试移植来自健康供体的粪便微生物群来治疗肠道GvHD。这项研究介绍了两例接受allo-HSCT的患者,这些患者后来被选为粪便微生物群移植 (FMT)。在第一例患者中,FMT导致症状完全缓解,而在第二例患者中未达到治疗效果。FMT消除了耐药病原体,即非常耐药的肠球菌属,但没有多药耐药的鲍曼不动杆菌或念珠菌属。需要进一步的研究,尤其是关于FMT在肠道类固醇耐药GvHD患者中的安全性以及移植菌群对allo-HSCT结局的远距离影响。FMT对于类固醇耐药GvHD患者的治疗似乎很有希望。

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