EHA Library - The official digital education library of European Hematology Association (EHA)

The role of the intestinal microbiota in graft-versus-host disease
EHA Library. van den Brink M. 06/14/17; 185029 Topic: 4Bf Acute and chronic graft versus host disease
Marcel van den Brink
Marcel van den Brink
Contributions
Learning Objectives
Nicolaus Kröger - Chair Introduction


Graft-versus Host Disease (GvHD) is a major cause of morbidity and mortality after allogeneic stem cell transplantation and it mainly caused by alloreactive donor T –cells. However, alloreactive donor T cells are also targeting recipient hematopoietic cells including the malignant cells. Several studies have shown a close correlation between the occurrence of GvHD and a reduced risk of relapse suggesting absence of GvHD implies also a less stronger graft –versus leukemia (GvL) effect. In this Educational update new insights into the pathogenesis of GvHD will be presented with special focus of the increasing role of the intestinal microbiota and its modulation by antibiotics, which may have a greater impact in preventing GvHD (CK Stein-Thoeringer and MRM van den Brink) . Furthermore, in the recent years new possibilities in preventing and treatment of GvHD by targeting JAK pathway or chemokine receptors are becoming available or are currently tested in clinical trial (R. Zeiser) and finally elegant ways of immunmodulation by selecting specific T cells as donor lymphocyte infusion may allow a better balance between GvHD and GvL effect (F. Falkenburg) will be presented

Learning Objectives of the manuscript
After viewing this presentation the participant will be able to:
- Understand pathogenesis of graft-versus Host Disease (GvHD) including new therapeutic optinons in prevention and treatment.
- Understand the emerging role of intestinal microbiota in GvHD and the impact of microbiota modulation by antibiotics.
- Understand how Graft-versus Leukemia (GvL) effect can be balanced to the risk of Graft-versus Host Disease.

Learning Objectives of the presentation
After viewing this presentation the participant will be able to:
- Describe the major changes observed in the intestinal microbiota of patients undergoing that are associated with graft-vs-host disease and transplant-related mortality.
- Recapitulate the impact of antibiotic therapy, broad- vs narrow-spectrum antibiotic, on clinical outcomes in allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients.
- Discuss current and putative future options for gut microbiota interventions to increase survival and gastrointestinal health in patients undergoing allo-HSCT.

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