{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:11:27Z","timestamp":1788383487280,"version":"build-2803163510"},"reference-count":51,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Acute myeloid leukemia (AML) remains a highly morbid malignancy in which outcomes are constrained not only by disease refractoriness and relapse, but also by therapy-related toxicity\u2014particularly infections, mucosal injury, and delayed hematopoietic reconstitution. The gut microbiota has emerged as a potentially modifiable layer of host vulnerability and resilience during AML treatment. Microbiome disruption is detectable already at diagnosis, even in antibiotic-na\u00efve patients, and is often characterized by reduced community diversity, depletion of anaerobic taxa linked to short-chain fatty acids (SCFAs) production, and enrichment of pathobiont-associated profiles. During induction, cytotoxic therapy and antimicrobials precipitates diversity loss, domination events, and persistent shifts beyond discharge. Clinically, the most consistent translational signal is the association between baseline or early-treatment microbiome features and infectious outcomes, while emerging data suggest that diagnosis-time microbiome structure may also relate to hematologic recovery kinetics. Mechanistic models converge on pathways linking barrier integrity, microbial metabolites (notably butyrate and other SCFAs), immune calibration, and inflammatory translocation of microbial products. These insights support hypotheses: antimicrobial stewardship may preserve microbiome function; ecosystem repair strategies such as autologous fecal microbiota transfer (A-FMT) are feasible and can restore community structure; and metabolite or nutritional interventions merit evaluation in immunocompromised hosts. Regimen-specific microbiome effects and microbiome\u2013drug interactions suggest that treatment choice could have downstream microbiome-mediated consequences. We synthesize evidence, outline interventional concepts, and define methodological priorities for next-generation trials assessing causality and clinical benefit. Progress will require longitudinal sampling, multi-omic integration (metabolomics, resistomics, and barrier\/inflammatory biomarkers), and interventional designs linking microbiome dynamics to clinically meaningful outcomes.<\/jats:p>","DOI":"10.3390\/antibiotics15040417","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T12:01:22Z","timestamp":1776686482000},"page":"417","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Gut Microbiota and Acute Myeloid Leukemia: State of the Art, Clinical Signals, and Translational Opportunities"],"prefix":"10.3390","volume":"15","author":[{"given":"Maria Eugenia","family":"Alvaro","sequence":"first","affiliation":[{"name":"Hematology Unit, Department of Onco-Hematology, Azienda Ospedaliera of Cosenza, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0698-1781","authenticated-orcid":false,"given":"Santino","family":"Caserta","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco-Hematology, Azienda Ospedaliera of Cosenza, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8504-3231","authenticated-orcid":false,"given":"Enrica Antonia","family":"Martino","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco-Hematology, Azienda Ospedaliera of Cosenza, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamdouh","family":"Skafi","sequence":"additional","affiliation":[{"name":"Emergency and Internal Medicine Department, Saint Joseph Hospital, Jerusalem 91192, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Bruzzese","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco-Hematology, Azienda Ospedaliera of Cosenza, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Amodio","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Lucia","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco-Hematology, Azienda Ospedaliera of Cosenza, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Olivito","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco-Hematology, Azienda Ospedaliera of Cosenza, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Labanca","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco-Hematology, Azienda Ospedaliera of Cosenza, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Mendicino","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco-Hematology, Azienda Ospedaliera of Cosenza, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Vigna","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco-Hematology, Azienda Ospedaliera of Cosenza, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2585-7073","authenticated-orcid":false,"given":"Fortunato","family":"Morabito","sequence":"additional","affiliation":[{"name":"AIL Sezione di Cosenza, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Gentile","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Onco-Hematology, Azienda Ospedaliera of Cosenza, 87100 Cosenza, Italy"},{"name":"Department of Pharmacy, Health and Nutritional Science, University of Calabria, 87036 Rende, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4505","DOI":"10.1038\/s41467-019-12476-z","article-title":"Interplay between the human gut microbiome and host metabolism","volume":"10","author":"Visconti","year":"2019","journal-title":"Nat. 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