Disruption of the intestinal microbiota occurs frequently in allogeneic hematopoietic cell transplantation (allo-HCT) recipients and predisposes them to development of graft-versus-host disease (GvHD). In a prospective, single-center, single-arm study, we investigated the effect of donor fecal microbiota transplantation (FMT) on symptoms of steroid-refractory or steroid-dependent, acute or late-onset acute intestinal GvHD in 15 individuals who had undergone allo-HCT. Study participants received a fecal suspension from an unrelated healthy donor via nasoduodenal infusion. Donor FMT was well tolerated, and infection-related adverse events did not seem to be related to the FMT procedure. In 10 of 15 study participants, a complete clinical response was observed within 1 month after FMT, without additional interventions to alleviate GvHD symptoms. This response was accompanied by an increase in gut microbial α-diversity, a partial engraftment of donor bacterial species, and increased abundance of butyrate-producing bacteria, including Clostridiales and Blautia species. In 6 of the 10 responding donor FMT recipients, immunosuppressant drug therapy was successfully tapered. Durable remission of steroid-refractory or steroid-dependent GvHD after donor FMT was associated with improved survival at 24 weeks after donor FMT. This study highlights the potential of donor FMT as a treatment for steroid-refractory or steroid-dependent GvHD, but larger clinical trials are needed to confirm the safety and efficacy of this procedure.

异体造血细胞移植（allo-HCT）受体中肠微生物群的破坏经常发生，并使他们易患移植物抗宿主病（GvHD）。在一项前瞻性，单中心，单臂研究中，我们研究了供者粪便微生物群移植（FMT）对15例接受过激素治疗的类固醇难治性或类固醇依赖性，急性或迟发性急性肠道GvHD症状的影响。 HCT。研究参与者通过鼻十二指肠输液从无关的健康供者处获得了粪便悬浮液。供体的FMT耐受性良好，与感染相关的不良事件似乎与FMT程序无关。在15名研究参与者中的10名中，在FMT后1个月内观察到了完全的临床反应，没有采取其他干预措施来缓解GvHD症状。蓝藻物种。在10个有响应的供体FMT接受者中，有6个成功地逐渐减少了免疫抑制剂药物治疗。供体FMT后持久缓解类固醇难治性或类固醇依赖性GvHD与改善供体FMT后24周生存率有关。这项研究强调了供体FMT作为治疗激素难治性或依赖激素的GvHD的潜力，但是需要更大的临床试验来确认该方法的安全性和有效性。