Table 1.
Summary of included studies regarding FMT as a therapeutic strategy for steroid-refractory or dependent gut aGvHD.
| First Author | Year | Number of Patients | Route of Administration | Donor | CR | PR | CR/Patients % | CR + PR/Patients % | Comments |
|---|---|---|---|---|---|---|---|---|---|
| Kakihana | 2016 | 4 | Nasoduodenal tube | Relative or Spouse | 3 | 1 | 75% | 100% | Response assessed within 7–14 days; in three cases a second FMT was needed. |
| Spindelboeck | 2017 | 3 | Colonoscopy | Unrelated or Related | 2 | 1 | 67% | 100% | Two patients achieved complete response with multiple FMT, one obtained a partial response after a single FMT with persistent grade I GVHD |
| Qi | 2018 | 8 | Nasoduodenal tube | Unrelated | 5 | 1 | 63% | 75% | The FMT recipients exhibited improved progression-free survival within 90 days after the diagnosis, compared with an historical control group, but no difference in overall survival. |
| Kaito | 2018 | 1 | Oral capsules | Related | - | 1 | - | 100% | Digestive symptoms improved soon after initiation of FMT. aGvHD improved to stage 1 after the second cycle of FMT with the improvement of endoscopic findings. |
| Shouval | 2018 | 7 | Oral capsules | Unrelated | 2 | 1 | 29% | 43% | - |
| Zhong | 2019 | 1 child | Jejunal tube under gastroduodenoscopy guidance | Unrelated | 1 | - | 100% | 100% | - |
| Biernat | 2020 | 2 | Nasogastric tube | Unrelated | 1 | 1 | 50% | 100% | In one case complete remission was achieved, but the patient later died due to liver aGvHD and bloodstream infections. In the second case only temporary reduction and death occurred by multiorgan failure. |
| Mao | 2020 | 1 | Oral capsules | Unrelated | 1 | - | 100% | 100% | Complete remission after the first cycle of FMT. Recurrence 11 days later, but remission achieved with a second cycle. |
| Von Lier | 2020 | 15 | Nasoduodenal tube | Unrelated | 10 | - | 67% | 67% | Response assessed at 28 days after FMT. In six of the 10 complete responders, immunosuppression was successfully tapered within six months. In the other four, GvHD symptoms returned upon tapering of immunosuppressive therapy |
| Total | - | 42 | - | - | 25 | 6 | 60% | 74% | - |
aGvHD: Graft versus Host Disease; allo-HSCT: allogeneic hematopoietic stem cells transplantation; CR: Complete Response; FMT: Fecal Microbiota Transplantation; PR: Partial Response.