Long-Term Analysis of Resilience of the Oral Microbiome in Allogeneic Stem Cell Transplant Recipients

Alexa M.G.A. Laheij*, Frederik R. Rozema, Michael T. Brennan, Inger von Bültzingslöwen, Stephanie J.M. van Leeuwen, Carin Potting, Marie Charlotte D.N.J.M. Huysmans, Mette D. Hazenberg, Bernd W. Brandt, Egija Zaura, Mark J. Buijs, Johannes J. de Soet, Nicole N.M. Blijlevens, Judith E. Raber-Durlacher

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Stem cell transplantation (SCT) is associated with oral microbial dysbiosis. However, long-term longitudinal data are lacking. Therefore, this study aimed to longitudinally assess the oral microbiome in SCT patients and to determine if changes are associated with oral mucositis and oral chronic graft-versus-host disease. Fifty allogeneic SCT recipients treated in two Dutch university hospitals were prospectively followed, starting at pre-SCT, weekly during hospitalization, and at 3, 6, 12, and 18 months after SCT. Oral rinsing samples were taken, and oral mucositis (WHO score) and oral chronic graft-versus-host disease (NIH score) were assessed. The oral microbiome diversity (Shannon index) and composition significantly changed after SCT and returned to pre-treatment levels from 3 months after SCT. Oral mucositis was associated with a more pronounced decrease in microbial diversity and with several disease-associated genera, such as Mycobacterium, Staphylococcus, and Enterococcus. On the other hand, microbiome diversity and composition were not associated with oral chronic graft-versus-host disease. To conclude, dysbiosis of the oral microbiome occurred directly after SCT but recovered after 3 months. Diversity and composition were related to oral mucositis but not to oral chronic graft-versus-host disease.

Original languageEnglish
Article number734
Pages (from-to)1-13
Number of pages13
JournalMicroorganisms
Volume10
Issue number4
Early online date29 Mar 2022
DOIs
Publication statusPublished - Apr 2022

Bibliographical note

Funding Information:
This study was performed as an ancillary study of the Orastem study, an international, observational, prospective study into the impact of oral complications after stem cell transplantation [17]. This study was approved by the Medical Research Ethical Committee from Amsterdam University Medical Centers location AMC and the Radboud University Medical Center Nijmegen (NL52117.018.15) and is registered in the Netherlands Trial Register (NL5645). The study was funded by the Dutch Cancer Foundation (ACTA 2014-7468). The study was carried out in accordance with the relevant guidelines and regulations. All patients provided written informed consent. The data on the oral microbiome, salivary proteome, and oral mucositis in autologous SCT patients from the same study are reported elsewhere [10,18]. The demographic and other relevant data were retrieved from the medical charts.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Funding

This study was performed as an ancillary study of the Orastem study, an international, observational, prospective study into the impact of oral complications after stem cell transplantation [17]. This study was approved by the Medical Research Ethical Committee from Amsterdam University Medical Centers location AMC and the Radboud University Medical Center Nijmegen (NL52117.018.15) and is registered in the Netherlands Trial Register (NL5645). The study was funded by the Dutch Cancer Foundation (ACTA 2014-7468). The study was carried out in accordance with the relevant guidelines and regulations. All patients provided written informed consent. The data on the oral microbiome, salivary proteome, and oral mucositis in autologous SCT patients from the same study are reported elsewhere [10,18]. The demographic and other relevant data were retrieved from the medical charts.

FundersFunder number
Dutch Cancer FoundationACTA 2014-7468

    Keywords

    • allogeneic stem cell transplant
    • conditioning
    • dysbiosis
    • oral graft-versus-host disease
    • oral microbiome
    • oral mucositis

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