Table 1.
Studies of FMT in allo-HSCT patients
| Authors | Study type | Number of patients | Age | Sex | Number of allo-HSCT patients | Immunocompromission | Outcome | Route of FMT Administration | Times of FMT | FMT-related adverse events (number of times) |
|---|---|---|---|---|---|---|---|---|---|---|
| FMT for GVHD treatment | ||||||||||
| Kakihana, 2016 Japan [14] | Pilot study | 4 | 46 (42–64) | 2 M 2F | 1 | No mention | 3 complete response ,1 partial response | Nasoduodenal tube | 7 |
Abdominal pain (4) Diarrhea (3) Pharyngolaryngeal pain (3) Nausea (1) Belch (1) |
| Spindelboeck, 2017 Austria [17] | Retrospective case series | 3 | 60 (53–61) | 1 M 2F | 3 | No mention | 2 complete resolution, 1 partial resolution | Colonoscopy | 9 | None |
| Qi, 2018 China [15] | Pilot study | 8 | 35.6 (20–48) | 3 M 5F | 8 | No mention | All the patients achieved clinical symptomatic remission | Nasoduodenal tube | 12 | None |
| Kaito, 2018 Japan [16] | Case report | 1 | 21 | F | 1 | No mention | Bacterial diversity was restored, with improvement of diarrhea | Oral capsule | Transient fever Herpes zoster | |
| Mao, 2020 China [67] | Case report | 1 | 31 | M | 1 | No mention | Intestinal aGVHD was controlled and did not recur again | Oral capsule | 2 | None |
| Bilinski, 2021 Poland [63] | Prospective multicenter study | 13 | 41.5 (23–66) | 9 M 4F | 13 | No mention | Overall response rate reached 62.5% (10/16) | Nasoduodenal tube | 16 |
Septic shock (1) Sepsis (1) Norovirus-mediated GI tract infection (1) |
| FMT for MDRB decolonization | ||||||||||
| Bilinski, 2017 Poland [51] | Prospective single-center study | 20 | 51 (22–77) | 14 M 6F | 6 | 8 patients with neutropenia (< 1.8 × 109 neutrophils/L), but not severe neutropenia (< 0.5 × 109 /L) | 15/20 (75%) decolonization | Nasoduodenal tube | 25 |
Vomiting (1) Diarrhea (25) |
| Innes, 2017 UK [68] | Case report | 1 | 63 | M | 1 | FMT was administrated 2 weeks before allo-HSCT | All kinds of MRD were decolonized | Nasogastric tube | 1 | Mild, self-limited nausea, loose stool and abdominal discomfort |
| Battipaglia, 2019 France [52] | Retrospective single-center study | 10 | 48 (16–64) | 4 M 6F | 6 (4 patients before allo-HSCT) | Neutrophil count was > 1 × 109 /L in all patients but one who had a neutrophil count of 0.17 × 109 /L | 7/10 (70%) decolonization |
Enema (10) Nasogastric tube (3) |
13 | Constipation (1) Diarrhea (2) |
| FMT for rCDI treatment | ||||||||||
| Webb, 2016 USA [69] | Retrospective case series | 7 | 43 (33–51) | 4 M 3F | 7 | No mention | 7/7 (100%) without rCDI | Nasojejunal tube (6) Colonoscopy (2) | 8 |
Mild self-limited GI discomfort/bloating (2) Self-limited chills (1) Bloating and urgency (2) (one patient was suspected of having small intestinal bacterial overgrowth) Self-limited right upper quadrant pain (1) |
| Moss, 2017 USA [70] | Retrospective, case series | 8 | 56 (38–71) | 3 M 5F | 6 (two patients after auto-HSCT) | No mention | 8/8 (100%) patients with resolution of rCDI | Oral capsule | 8 | Vomiting (1) |
| Bluestone, 2018 USA [71] | Retrospective, case series | 3 | 8 (2–12) | 2 M 1F | 3 | No mention | 1/3 (33.3%) patient without rCDI | Gastric tube (6) Colonoscopy (1) Gastrojejunal tube (1) | 8 | Nausea and retching (1) Vomiting (1) |
| FMT for intestinal microbiome reconstruction | ||||||||||
| DeFilipp, 2018 USA [72] | Open-label single-group pilot study | 13 | 63 (26–71) | 6 M 7F | 13 | FMT capsules were administered no later than 4 weeks after neutrophil engraftment | FMT led to early expansion of microbiome diversity | Oral capsule | 13 | Severe abdominal pain (1) |
| Taur, 2019 USA [73] | Randomized-controlled clinical trial | 14 | 52.5 (32–71) | 6 M 8F | 14 | FMT was administrated a median of 18 (8–27) days after engraftment | Diversity and composition of gut microbiota were restored | Enema | 14 | None |
| The total number of FMT times | 136 | |||||||||
| Diarrhea | n = 31 (22.79%) | |||||||||
| Abdominal pain/discomfort/bloating/urgency | n = 10 (7.35%) | |||||||||
| Nausea | n = 3 (2.21%) | |||||||||
| Vomiting | n = 3 (2.21%) | |||||||||
| Pharyngolaryngeal pain | n = 3 (2.21%) | |||||||||
| Others (belch/fever/herpes zoster/septic shock/sepsis/norovirus-mediated GI tract infection/constipation/chills/right upper quadrant pain) | n = 9 (6.62%) | |||||||||
allo-HSCT allogeneic hematopoietic stem cell transplantation, FMT fecal microbiota transplantation, GVHD graft-versus-host disease, M male, F female, aGVHD acute graft-versus-host disease, GI gastrointestinal, MDRB multidrug-resistant bacteria, rCDI recurrent Clostridium difficile infection, auto-HSCT autogeneic hematopoietic stem cell transplantation