Daniel Wolff, MD, PhD, University Hospital of Regensburg, Regensburg, Germany, discusses the impact of gut decontamination in the context of allogeneic stem cell transplantation (alloSCT). Whilst it is known that the microbiome impacts transplant outcomes, it is less clear whether gut decontamination has a negative impact on survival. Evidence has suggested that broad spectrum antibiotics used in clinical interventions are likely to be detrimental. Dr Wolff emphasizes that this impact is context-dependent and that more evidence from well-designed clinical trials, as well as expert guidance, is necessary to evaluate antibiotic prophylaxis prior to alloSCT and create general recommendations, as individual-based interventions using microbiome transfer performed outside the clinical setting can potentially be detrimental. This interview took place at the 6th Congress on Controversies in Stem Cell Transplantation and Cellular Therapies (COSTEM), which took place virtually.
