Document Type

Article

Publication Date

5-13-2025

Keywords

JGM, Humans, Hematopoietic Stem Cell Transplantation, Dysbiosis, Male, Female, Middle Aged, Adult, Skin, Transplantation, Homologous, Microbiota, Graft vs Host Disease, Aged

JAX Source

Blood Adv. 2025;9(9):2173-82

ISSN

2473-9537

PMID

39853270

DOI

https://doi.org/10.1182/bloodadvances.2021004792

Grant

J.O. is supported by the National Institutes of Health (NIH) grants DP2 GM126893- 01, 1U54NS105539, 1 U19 AI142733, and 1 R21 AR075174, National Science Foundation grant 1853071, the American Can- cer Society, and the Leo Foundation. A.E. is supported by NIH grant K99GM135540, the Jackson Laboratory Scholars Program, and the Maximilian & Marion Hoffman Foundation Postdoctoral fellow.

Abstract

Gut dysbiosis is linked to mortality and the development of graft-versus-host disease after hematopoietic stem cell transplantation (HSCT), but the impact of cutaneous dysbiosis remains unexplored. We performed a pilot observational study, obtained retroauricular and forearm skin swabs from 12 adult patients before conditioning chemotherapy/radiation and at 1 week, 1 month, and 3 months after allogeneic HSCT, and performed shotgun metagenomic sequencing. The cutaneous microbiome among HSCT patients was enriched for gram-negative bacteria such as Escherichia coli and Pseudomonas, fungi, and viruses. Enrichment with bacteriophages and Polyomavirus species was observed among patients who died within 1 year. We observed longitudinal stability of the cutaneous microbiome at the 3-month time point among those who survived beyond 1 year after HSCT, although these may simply be a reflection of the overall medical status of the patients. There was no association with fungal abundance and any of the outcomes observed. The cutaneous microbiome may be a reservoir of pathobionts among allogeneic HSCT patients. Our findings suggest that cutaneous dysbiosis exists after HSCT, but the ultimate implication of this to patient outcomes remains to be seen through larger studies.

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