Hematology · Pediatrics · 2 h ago
2′-FL preserves microbiome diversity after pediatric stem cell transplant
A prospective phase 1/2 study evaluated daily oral 2′-fucosyllactose (2′-FL) in 70 children undergoing allogeneic hematopoietic stem cell transplantation. Microbiome diversity was preserved in treated patients, and acute gastrointestinal graft-versus-host disease was less frequent than in contemporary controls, although the comparison was not randomized.
- Prospective phase 1/2 study included 70 transplant patients.
- Microbiome diversity was preserved through day +30.
- GI GVHD occurred in 0% versus 17% of controls.
- Nonrandomized comparison limits interpretation of clinical outcomes.
Dysbiosis after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is associated with gastrointestinal graft-versus-host disease (GI GVHD). In this prospective phase 1/2 study, 70 patients received daily oral 2′-fucosyllactose (2′-FL) from the start of conditioning through day +30. The primary endpoints were safety and tolerability in phase 1 and longitudinal microbiome diversity in phase 2. Correlative analyses included patients with at least 60% adherence; 29 age-matched patients with available samples from an institutional biorepository served as contemporary controls.
2′-FL was reported as safe and well tolerated. Shannon diversity was preserved in recipients, while it declined in controls from baseline to day +30 (P=.04). The intervention was associated with higher levels of Bifidobacteria and Blautia. Grade II–IV acute GI GVHD occurred in 0% of 2′-FL recipients versus 17% of controls (P=.009); adenovirus reactivation was also 0% versus 17% (P=.009). The findings are preliminary: the control group was not randomized, and the study was designed primarily to assess safety and microbiome outcomes. The results do not establish that 2′-FL prevents GVHD or infections.
In practice
For children undergoing allo-HSCT, daily 2′-FL was reported as safe and well tolerated and was associated with preserved microbiome diversity. GI GVHD and adenovirus reactivation were less frequent than in contemporary controls, but those comparisons came from a nonrandomized study with biorepository controls; the trial was designed primarily around safety and microbiome outcomes. These findings are promising but do not establish preventive efficacy or support changing transplant care.
AI-generated clinical interpretation · Not editor-reviewed
Is this summary clinically accurate?
Help fellow clinicians: your rating sends inaccurate summaries straight to our editors.
Sign in to rate this summary →Source
Blood: Human milk oligosaccharide (2′-FL) modifies the gut microbiome in children after bone marrow transplant ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.