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Reduced microbial diversity, depletion of short-chain fatty acid (SCFA)\u2013producing commensals, and expansion of opportunistic taxa are recurrent findings across cohorts. Such patterns correlate with inflammatory signaling, impaired barrier function, and shifts in immune responses affecting treatment tolerance and hematopoietic recovery. Clinical associations show greater consistency for treatment-related outcomes, including infection risk, mucosal injury, and delayed immune reconstitution, than for leukemogenesis. Evidence supporting a direct causal role of specific microbial taxa in disease initiation remains limited. This review examines microbiome composition, microbial taxa, and mechanistic pathways in leukemia, with emphasis on how microbiome alterations may influence leukemia biology, disease progression, treatment response, and clinical outcomes, while acknowledging that most human evidence remains associative.<\/jats:p>","DOI":"10.3389\/fcimb.2026.1842279","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:52:40Z","timestamp":1783486360000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Host\u2013microbiome interactions in leukemia: mechanisms, treatment response, and clinical implications"],"prefix":"10.3389","volume":"16","author":[{"given":"Jhommara","family":"Bautista","sequence":"first","affiliation":[{"name":"Cancer Research Group (CRG), Faculty of Medicine, Universidad de Las Am\u00e9ricas","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudy","family":"Carri\u00f3n-Ruiz","sequence":"additional","affiliation":[{"name":"Hospital de Especialidades Carlos Andrade Mar\u00edn","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Bourne-Cabezas","sequence":"additional","affiliation":[{"name":"Cancer Research Group (CRG), Faculty of Medicine, Universidad de Las Am\u00e9ricas","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Ayala","family":"Robles","sequence":"additional","affiliation":[{"name":"Cancer Research Group (CRG), Faculty of Medicine, Universidad de Las Am\u00e9ricas","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Maria","family":"Velez-Navarrete","sequence":"additional","affiliation":[{"name":"Sociedad Ecuatoriana de Hematolog\u00eda","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"L\u00f3pez-Cort\u00e9s","sequence":"additional","affiliation":[{"name":"Cancer Research Group (CRG), Faculty of Medicine, Universidad de Las Am\u00e9ricas","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1536","DOI":"10.12688\/f1000research.159318.2","article-title":"Advances in leukemia detection and classification: a systematic review of AI and image processing techniques","volume":"13","author":"Achir","year":"2024","journal-title":"F1000Res."},{"key":"B2","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1038\/s41586-025-08938-8","article-title":"Microbial metabolite drives ageing-related clonal haematopoiesis via ALPK1","volume":"642","author":"Agarwal","year":"2025","journal-title":"Nature"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics15040417","article-title":"Gut microbiota and acute myeloid leukemia: state of the art, clinical signals, and translational opportunities","volume":"15","author":"Alvaro","year":"2026","journal-title":"Antibiotics (Basel)"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2025.1559033","article-title":"Significant changes in gut microbiota and SCFAs among patients with newly diagnosed acute myeloid leukemia","volume":"16","author":"An","year":"2025","journal-title":"Front. 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