Korean J Med.  2021 Aug;96(4):358-362. 10.3904/kjm.2021.96.4.358.

Fecal Microbiota Transplantation for Treating Steroid-Refractory Acute Graft-versus-Host Disease of the Gut

• Yeon SH
• Lee MW
• Jo DY
• Heo BY
• Kwon J
• Song IC

• KMID: 2519164
• DOI: http://doi.org/10.3904/kjm.2021.96.4.358

Abstract

Restoring the microbiota via fecal microbiota transplantation (FMT) can be an effective treatment for steroid-refractory acute graft-versus-host disease (GVHD) of the gut. Here, we report two adult patients who underwent FMT to treat steroid-refractory acute GVHD of the gut. The first patient was a 43-year-old man who underwent allogeneic hematopoietic stem cell transplantation (HSCT) with cells from a matched sibling donor. The second patient was a 70-year-old woman who underwent haplo-identical HSCT with cells from her son. Gut GVHD developed at 7 and 4 weeks after HSCT, respectively. After undergoing FMT, the clinical symptoms improved; the first patient had a complete response and the second patient had a partial response. Microbial analyses using RNA gene sequencing showed that a diverse fecal microbiome was recovered by 4 weeks after FMT. FMT should be considered an effective therapeutic option for managing steroid-refractory acute GVHD of the gut.

Keyword

대변미생물무리이식; 이식편대숙주병; 동종 조혈모세포이식; Fecal microbiota transplantation; Graft vs host disease; Hematopoietic stem cell transplantation