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EBMT 2025 | The potential of microbiome modulation for preventing and treating acute GvHD

Florent Malard, MD, PhD, Saint-Antoine Hospital and Sorbonne University, Paris, France, comments on the potential of microbiome modulation in treating gastrointestinal (GI) acute graft-versus-host disease (GvHD), for example, through fecal microbiota transplantation (FMT). Dr Malard also highlights that ongoing studies are investigating gut modulation strategies as a prophylactic measure for transplant complications. This interview took place at the 51st Annual Meeting of the EBMT in Florence, Italy.

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Transcript

For the microbiome modulation, of course we can use, as I just say, FMT as a treatment for GI acute graft-versus-host disease. Now we have more and more data that show that FMT is an effective treatment for those patients. If patients fail steroids, fail ruxolitinib, we can use FMT to treat GI acute graft-versus-host disease, and there is also some systemic effect on the skin and the liver...

For the microbiome modulation, of course we can use, as I just say, FMT as a treatment for GI acute graft-versus-host disease. Now we have more and more data that show that FMT is an effective treatment for those patients. If patients fail steroids, fail ruxolitinib, we can use FMT to treat GI acute graft-versus-host disease, and there is also some systemic effect on the skin and the liver. 

It’s great to treat acute graft-versus-host disease, but it will be better to prevent acute acute graft-versus-host disease. And there is also some ongoing study that try to evaluate some FMT to prevent the complications after stem cell transplantation, including acute graft-versus-host disease. And we also have some other approaches of gut modulation that are ongoing, that are reducing the use of antibiotics, using prebiotics, using also maybe postbiotics one day, and at the end, we may need to combine some of these approaches to be very effective for the patients.

 

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Disclosures

BMS: Honoraria; Therakos/Mallinckrodt: Honoraria; Sanofi: Honoraria; JAZZ Pharmaceuticals: Honoraria; Gilead: Honoraria; Novartis: Honoraria; AstraZeneca: Honoraria; MSD: Honoraria.