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

Giorgia Battipaglia, Florent Malard, Marie Therèse Rubio, Annalisa Ruggeri, Anne Claire Mamez, Eolia Brissot, Federica Giannotti, Remy Dulery, Anne Christine Joly, Minh Tam Baylatry, Marie Jeanne Kossmann, Jacques Tankovic, Laurent Beaugerie, Harry Sokol, Mohamad Mohty

Research output: Contribution to journalArticle

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. Stools 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 microbiota 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.

Original languageEnglish
Pages (from-to)1682-1688
Number of pages7
JournalHaematologica
Volume104
Issue number8
DOIs
Publication statusPublished - Jul 31 2019

ASJC Scopus subject areas

  • Hematology

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    Battipaglia, G., Malard, F., Rubio, M. T., Ruggeri, A., Mamez, A. C., Brissot, E., Giannotti, F., Dulery, R., Joly, A. C., Baylatry, M. T., Kossmann, M. J., Tankovic, J., Beaugerie, L., Sokol, H., & Mohty, M. (2019). Fecal microbiota transplantation before or after allogeneic hematopoietic transplantation in patients with hematologic malignancies carrying multidrug-resistance bacteria. Haematologica, 104(8), 1682-1688. https://doi.org/10.3324/haematol.2018.198549