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Fecal microbiota transplantation before or after allogeneic hematopoietic transplantation in patients with hematologic malignancies carrying multidrug-resistance bacteria
Giorgia Battipaglia, Florent Malard, Marie Therèse Rubio, Annalisa Ruggeri, Anne Claire Mamez, Eolia Brissot, Federica Giannotti, Remy Dulery, Anne Christine Joly, Minh Tam Baylatry, Marie Jeanne Kossmann, Jacques Tankovic, Laurent Beaugerie, Harry Sokol, Mohamad Mohty
Haematologica August 2019 104: 1682-1688; doi:10.3324/haematol.2018.198549
Giorgia Battipaglia
Department of Hematology, Saint Antoine Hospital, Paris, France Federico II University, Hematology Department, Naples, Italy
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  • For correspondence: giorgia.battipaglia@aphp.fr
Florent Malard
Department of Hematology, Saint Antoine Hospital, Paris, France Sorbonne Universités, UPMC Univ Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), F-75012 Paris, France
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Marie Therèse Rubio
Department of Hematology, Saint Antoine Hospital, Paris, France Service d’Hématologie, Hôpital Brabois, CHRU Nancy, France CMRS UMR 7563, IMoPa, Biopole de l’Université de Lorraine, France
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Annalisa Ruggeri
Department of Hematology, Saint Antoine Hospital, Paris, France
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Anne Claire Mamez
Department of Hematology, Saint Antoine Hospital, Paris, France
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Eolia Brissot
Department of Hematology, Saint Antoine Hospital, Paris, France Sorbonne Universités, UPMC Univ Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), F-75012 Paris, France
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Federica Giannotti
Department of Hematology, Saint Antoine Hospital, Paris, France
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Remy Dulery
Department of Hematology, Saint Antoine Hospital, Paris, France
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Anne Christine Joly
Microbiote Transplant Préparations Unit, Pharmacy Department, Saint Antoine Hospital, Paris, France
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Minh Tam Baylatry
Microbiote Transplant Préparations Unit, Pharmacy Department, Saint Antoine Hospital, Paris, France
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Marie Jeanne Kossmann
Unité d’Hygiène et de Lutte Contre les Infections Nosocomiales, Saint Antoine Hospital, Paris, France
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Jacques Tankovic
Department of Bacteriology, Saint Antoine Hospital, Paris, France
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Laurent Beaugerie
Microbiote Transplant Préparations Unit, Pharmacy Department, Saint Antoine Hospital, Paris, France Department of Gastroenterology, Saint Antoine Hospital, AP-HP, Paris, France
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Harry Sokol
Sorbonne Universités, UPMC Univ Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), F-75012 Paris, France Department of Gastroenterology, Saint Antoine Hospital, AP-HP, Paris, France Sorbonne Université, École Normale Supérieure, PSL Research University, CNRS, INSERM, AP-HP, Hôpital Saint-Antoine, Laboratoire de Biomolécules, LBM, F-75005 Paris, France INRA, UMR1319 Micalis & AgroParisTech, Jouy en Josas, France
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Mohamad Mohty
Department of Hematology, Saint Antoine Hospital, Paris, France Sorbonne Universités, UPMC Univ Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), F-75012 Paris, France
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Author Affiliations

  1. Giorgia Battipaglia1,2⇑,
  2. Florent Malard1,3,
  3. Marie Therèse Rubio1,4,5,
  4. Annalisa Ruggeri1,
  5. Anne Claire Mamez1,
  6. Eolia Brissot1,3,
  7. Federica Giannotti1,
  8. Remy Dulery1,
  9. Anne Christine Joly6,
  10. Minh Tam Baylatry6,
  11. Marie Jeanne Kossmann7,
  12. Jacques Tankovic8,
  13. Laurent Beaugerie6,9,
  14. Harry Sokol3,9,10,11,* and
  15. Mohamad Mohty1,3,*
  1. 1Department of Hematology, Saint Antoine Hospital, Paris, France
  2. 2Federico II University, Hematology Department, Naples, Italy
  3. 3Sorbonne Universités, UPMC Univ Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), F-75012 Paris, France
  4. 4Service d’Hématologie, Hôpital Brabois, CHRU Nancy, France
  5. 5CMRS UMR 7563, IMoPa, Biopole de l’Université de Lorraine, France
  6. 6Microbiote Transplant Préparations Unit, Pharmacy Department, Saint Antoine Hospital, Paris, France
  7. 7Unité d’Hygiène et de Lutte Contre les Infections Nosocomiales, Saint Antoine Hospital, Paris, France
  8. 8Department of Bacteriology, Saint Antoine Hospital, Paris, France
  9. 9Department of Gastroenterology, Saint Antoine Hospital, AP-HP, Paris, France
  10. 10Sorbonne Université, École Normale Supérieure, PSL Research University, CNRS, INSERM, AP-HP, Hôpital Saint-Antoine, Laboratoire de Biomolécules, LBM, F-75005 Paris, France
  11. 11INRA, UMR1319 Micalis & AgroParisTech, Jouy en Josas, France
  1. Correspondence:
    GIORGIA BATTIPAGLIA giorgia.battipaglia{at}aphp.fr
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Abstract

Fecal microbiota transplantation is an effective treatment in recurrent Clostridium difficile infection. Promising results to eradicate multidrug-resistant bacteria have also been reported with this procedure, but there are safety concerns in immunocompromised patients. We report results in ten adult patients colonized with multidrug-resistant bacteria, undergoing fecal microbiota transplantation before (n=4) or after (n=6) allogeneic hematopoietic stem cell transplantation for hematologic malignancies. were obtained from healthy related or unrelated donors. Fecal material was delivered either by enema or via nasogastric tube. Patients were colonized or had infections from either carbapenemase-producing bacteria (n=8) or vancomycin-resistant enterococci (n=2). Median age at fecal microbiota transplantation was 48 (range, 16-64) years. Three patients needed a second transplant from the same donor due to initial failure of the procedure. With a median follow up of 13 (range, 4-40) months, decolonization was achieved in seven of ten patients. In all patients, fecal micro-biota transplantation was safe: one patient presented with constipation during the first five days after FMT and two patients had grade I diarrhea. One case of gut grade III acute graft-versus-host disease occurred after fecal microbiota transplantation. In patients carrying or infected by multidrug-resistant bacteria, fecal microbiota transplantation is an effective and safe decolonization strategy, even in those with hematologic malignancies undergoing hematopoietic stem cell transplantation.

  • Received May 29, 2018.
  • Accepted January 31, 2019.
  • Copyright© 2019 Ferrata Storti Foundation

Material published in Haematologica is covered by copyright. All rights are reserved to the Ferrata Storti Foundation. Use of published material is allowed under the following terms and conditions:

https://creativecommons.org/licenses/by-nc/4.0/legalcode. Copies of published material are allowed for personal or internal use. Sharing published material for non-commercial purposes is subject to the following conditions:

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Vol 104 Issue 8

Haematologica: 104 (8)
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Fecal microbiota transplantation before or after allogeneic hematopoietic transplantation in patients with hematologic malignancies carrying multidrug-resistance bacteria
Giorgia Battipaglia, Florent Malard, Marie Therèse Rubio, Annalisa Ruggeri, Anne Claire Mamez, Eolia Brissot, Federica Giannotti, Remy Dulery, Anne Christine Joly, Minh Tam Baylatry, Marie Jeanne Kossmann, Jacques Tankovic, Laurent Beaugerie, Harry Sokol, Mohamad Mohty
Haematologica Aug 2019, 104 (8) 1682-1688; DOI: 10.3324/haematol.2018.198549

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Giorgia Battipaglia, Florent Malard, Marie Therèse Rubio, Annalisa Ruggeri, Anne Claire Mamez, Eolia Brissot, Federica Giannotti, Remy Dulery, Anne Christine Joly, Minh Tam Baylatry, Marie Jeanne Kossmann, Jacques Tankovic, Laurent Beaugerie, Harry Sokol, Mohamad Mohty
Haematologica Aug 2019, 104 (8) 1682-1688; DOI: 10.3324/haematol.2018.198549
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