{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:20:12Z","timestamp":1790889612709,"version":"4.1.0"},"reference-count":92,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The gut microbiome plays a crucial role in modulating the efficacy and toxicity of cancer therapies, particularly in hematological malignancies. This review examines the dynamic interplay between gut microbiota and cancer treatments, such as chemotherapy, immunotherapy, and hematopoietic stem cell transplantation (HSCT). Disruptions in the gut microbiome, known as dysbiosis, are associated with adverse effects like gastrointestinal toxicity, neutropenia and cardiotoxicity during chemotherapy. Conversely, the supplementation of probiotics has shown potential in mitigating these side effects by enhancing gut barrier function and regulating immune responses. In HSCT, a higher diversity of gut microbiota is linked to better patient outcomes, including reduced graft-versus-host disease (GVHD) and improved survival rates. The microbiome also influences the efficacy of immunotherapies, such as immune checkpoint inhibitors and CAR-T cell therapy, by modulating immune pathways. Research suggests that certain bacteria, including Bifidobacterium and Akkermansia muciniphila, enhance therapeutic responses by promoting immune activation. Given these findings, modulating the gut microbiome could represent a novel strategy for improving cancer treatment outcomes. The growing understanding of the microbiome\u2019s impact on cancer therapy underscores its potential as a target for personalized medicine and offers new opportunities to optimize treatment efficacy while minimizing toxic side effects.<\/jats:p>","DOI":"10.3390\/jcm14092982","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T10:42:09Z","timestamp":1745577729000},"page":"2982","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["A Literature Review on the Impact of the Gut Microbiome on Cancer Treatment Efficacy, Disease Evolution and Toxicity: The Implications for Hematological Malignancies"],"prefix":"10.3390","volume":"14","author":[{"given":"Ioana Gabriela","family":"Dumitru","sequence":"first","affiliation":[{"name":"Faculty of Medicine, \u201cLucian Blaga\u201d University of Sibiu, 550024 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Bogdan","family":"Todor","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cLucian Blaga\u201d University of Sibiu, 550024 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9111-6088","authenticated-orcid":false,"given":"Cristian","family":"Ichim","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cLucian Blaga\u201d University of Sibiu, 550024 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudiu","family":"Helgiu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cLucian Blaga\u201d University of Sibiu, 550024 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Helgiu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cLucian Blaga\u201d University of Sibiu, 550024 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s12967-017-1175-y","article-title":"Influence of Diet on the Gut Microbiome and Implications for Human Health","volume":"15","author":"Singh","year":"2017","journal-title":"J. Transl. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1093\/femsre\/fuz002","article-title":"Lipopolysaccharide Structures of Gram-Negative Populations in the Gut Microbiota and Effects on Host Interactions","volume":"43","author":"Silipo","year":"2019","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1038\/s41467-017-02651-5","article-title":"Microbiota Derived Short Chain Fatty Acids Promote Histone Crotonylation in the Colon through Histone Deacetylases","volume":"9","author":"Fellows","year":"2018","journal-title":"Nat. Commun."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1002\/cncr.33400","article-title":"Clinical Effects and Applications of the Gut Microbiome in Hematologic Malignancies","volume":"127","author":"Sudakaran","year":"2021","journal-title":"Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Mirzaei, R., Afaghi, A., Babakhani, S., Sohrabi, M.R., Hosseini-Fard, S.R., Babolhavaeji, K., Khani Ali Akbari, S., Yousefimashouf, R., and Karampoor, S. (2021). Role of Microbiota-Derived Short-Chain Fatty Acids in Cancer Development and Prevention. Biomed. Pharmacother., 139.","DOI":"10.1016\/j.biopha.2021.111619"},{"key":"ref_6","first-page":"10139","article-title":"Microbiota and Hematological Diseases","volume":"16","year":"2022","journal-title":"Int. J. Hematol.-Oncol. Stem Cell Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1126\/science.1241165","article-title":"The Microbial Metabolites, Short-Chain Fatty Acids, Regulate Colonic Treg Cell Homeostasis","volume":"341","author":"Smith","year":"2013","journal-title":"Science"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Nastasi, C., Candela, M., Bonefeld, C.M., Geisler, C., Hansen, M., Krejsgaard, T., Biagi, E., Andersen, M.H., Brigidi, P., and \u00d8dum, N. (2015). The Effect of Short-Chain Fatty Acids on Human Monocyte-Derived Dendritic Cells. Sci. Rep., 5.","DOI":"10.1038\/srep16148"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1182\/blood-2015-04-574392","article-title":"The Human Microbiome in Hematopoiesis and Hematologic Disorders","volume":"126","author":"Manzo","year":"2015","journal-title":"Blood"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"5029","DOI":"10.1038\/s41467-019-13036-1","article-title":"Evaluation of 16S rRNA Gene Sequencing for Species and Strain-Level Microbiome Analysis","volume":"10","author":"Johnson","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"260","DOI":"10.2174\/1389200221666200303113830","article-title":"Chemical Metabolism of Xenobiotics by Gut Microbiota","volume":"21","author":"Nakov","year":"2020","journal-title":"Curr. Drug Metab."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.trsl.2016.08.002","article-title":"Gut Microbiome Interactions with Drug Metabolism, Efficacy, and Toxicity","volume":"179","author":"Wilson","year":"2017","journal-title":"Transl. Res."},{"key":"ref_13","first-page":"375","article-title":"The Impact of the Gut Microbiota on Drug Metabolism and Clinical Outcome","volume":"89","author":"Enright","year":"2016","journal-title":"Yale J. Biol. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1038\/nrclinonc.2009.146","article-title":"Cyclophosphamide and Cancer: Golden Anniversary","volume":"6","author":"Emadi","year":"2009","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1126\/science.1240537","article-title":"The Intestinal Microbiota Modulates the Anticancer Immune Effects of Cyclophosphamide","volume":"342","author":"Viaud","year":"2013","journal-title":"Science"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.critrevonc.2019.09.003","article-title":"Gut Microbiota and Cancer: How Gut Microbiota Modulates Activity, Efficacy and Toxicity of Antitumoral Therapy","volume":"143","author":"Gori","year":"2019","journal-title":"Crit. Rev. Oncol.\/Hematol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Aghamajidi, A., and Maleki Vareki, S. (2022). The Effect of the Gut Microbiota on Systemic and Anti-Tumor Immunity and Response to Systemic Therapy against Cancer. Cancers, 14.","DOI":"10.3390\/cancers14153563"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"4832","DOI":"10.1038\/s41467-018-07305-8","article-title":"Microbiota-Driven Interleukin-17-Producing Cells and Eosinophils Synergize to Accelerate Multiple Myeloma Progression","volume":"9","author":"Calcinotto","year":"2018","journal-title":"Nat. Commun."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/j.immuni.2016.09.009","article-title":"Enterococcus Hirae and Barnesiella Intestinihominis Facilitate Cyclophosphamide-Induced Therapeutic Immunomodulatory Effects","volume":"45","author":"Waldschmitt","year":"2016","journal-title":"Immunity"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Yan, H., Su, R., Xue, H., Gao, C., Li, X., and Wang, C. (2021). Pharmacomicrobiology of Methotrexate in Rheumatoid Arthritis: Gut Microbiome as Predictor of Therapeutic Response. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.789334"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e01301-23","DOI":"10.1128\/msystems.01301-23","article-title":"Gut-Derived Metabolite 3-Methylxanthine Enhances Cisplatin-Induced Apoptosis via Dopamine Receptor D1 in a Mouse Model of Ovarian Cancer","volume":"9","author":"Mai","year":"2024","journal-title":"mSystems"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1002\/cam4.3694","article-title":"Modulatory Effects of Gut Microbiome in Cancer Immunotherapy: A Novel Paradigm for Blockade of Immune Checkpoint Inhibitors","volume":"10","author":"Rezasoltani","year":"2021","journal-title":"Cancer Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/j.chom.2022.07.003","article-title":"Butyrate-Producing Eubacterium Rectale Suppresses Lymphomagenesis by Alleviating the TNF-Induced TLR4\/MyD88\/NF-\u03baB Axis","volume":"30","author":"Lu","year":"2022","journal-title":"Cell Host Microbe"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1802866","DOI":"10.1080\/19490976.2020.1802866","article-title":"Gut Microbes from the Phylogenetically Diverse Genus Eubacterium and Their Various Contributions to Gut Health","volume":"12","author":"Mukherjee","year":"2020","journal-title":"Gut Microbes"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Li, B., Han, Y., Fu, Z., Chai, Y., Guo, X., Du, S., Li, C., and Wang, D. (2024). The Causal Relationship between Gut Microbiota and Lymphoma: A Two-Sample Mendelian Randomization Study. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1397485"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Singh, V., Lee, G., Son, H., Koh, H., Kim, E.S., Unno, T., and Shin, J.-H. (2023). Butyrate Producers, \u201cThe Sentinel of Gut\u201d: Their Intestinal Significance with and beyond Butyrate, and Prospective Use as Microbial Therapeutics. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.1103836"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Yang, Q., Wei, Y., Zhu, Y., Guo, J., Zhang, J., He, Y., Li, X., Liu, J., and Zhou, W. (2023). The Interaction between Gut Microbiota and Host Amino Acids Metabolism in Multiple Myeloma. Cancers, 15.","DOI":"10.3390\/cancers15071942"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Zhang, L., Xiang, Y., Li, Y., and Zhang, J. (2022). Gut Microbiome in Multiple Myeloma: Mechanisms of Progression and Clinical Applications. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.1058272"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Lin, Z., Mao, D., Jin, C., Wang, J., Lai, Y., Zhang, Y., Zhou, M., Ge, Q., Zhang, P., and Sun, Y. (2023). The Gut Microbiota Correlate with the Disease Characteristics and Immune Status of Patients with Untreated Diffuse Large B-Cell Lymphoma. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1105293"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1848158","DOI":"10.1080\/19490976.2020.1848158","article-title":"Gut Bacteroides Species in Health and Disease","volume":"13","author":"Zafar","year":"2021","journal-title":"Gut Microbes"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3390\/hematolrep16010007","article-title":"The Gut Microbiome Correlated to Chemotherapy Efficacy in Diffuse Large B-Cell Lymphoma Patients","volume":"16","author":"Xu","year":"2024","journal-title":"Hematol. Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"5455","DOI":"10.1182\/blood-2019-121643","article-title":"Alterations of Gut Microbiome in Untreated Chronic Lymphocytic Leukemia (CLL); Future Therapeutic Potentials","volume":"134","author":"Kawari","year":"2019","journal-title":"Blood"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3237","DOI":"10.3324\/haematol.2023.284693","article-title":"The Diversity of the Microbiome Impacts Chronic Lymphocytic Leukemia Development in Mice and Humans","volume":"109","author":"Faitova","year":"2024","journal-title":"Haematol"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"552","DOI":"10.3892\/ol.2024.14685","article-title":"Increased Abundance of Firmicutes and Depletion of Bacteroidota Predicts Poor Outcome in Chronic Lymphocytic Leukemia","volume":"28","author":"Paziewska","year":"2024","journal-title":"Oncol. Lett."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"4222","DOI":"10.1158\/0008-5472.CAN-13-0022","article-title":"Intestinal Bacteria Modify Lymphoma Incidence and Latency by Affecting Systemic Inflammatory State, Oxidative Stress, and Leukocyte Genotoxicity","volume":"73","author":"Yamamoto","year":"2013","journal-title":"Cancer Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1097\/MIB.0000000000000332","article-title":"Using Corticosteroids to Reshape the Gut Microbiome: Implications for Inflammatory Bowel Diseases","volume":"21","author":"Huang","year":"2015","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1002\/JLB.5HI1117-446RR","article-title":"Frontline Science: Microbiota Reconstitution Restores Intestinal Integrity after Cisplatin Therapy","volume":"103","author":"Payne","year":"2018","journal-title":"J. Leukoc. Biol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1038\/s41420-022-01015-3","article-title":"Overabundance of Veillonella Parvula Promotes Intestinal Inflammation by Activating Macrophages via LPS-TLR4 Pathway","volume":"8","author":"Zhan","year":"2022","journal-title":"Cell Death Discov."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Maddern, A.S., Coller, J.K., Bowen, J.M., and Gibson, R.J. (2023). The Association between the Gut Microbiome and Development and Progression of Cancer Treatment Adverse Effects. Cancers, 15.","DOI":"10.3390\/cancers15174301"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1080\/10408390903551747","article-title":"Evidence Supporting the Use of Probiotics for the Prevention and Treatment of Chemotherapy-Induced Intestinal Mucositis","volume":"51","author":"Prisciandaro","year":"2011","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e457","DOI":"10.1097\/MPH.0000000000001956","article-title":"Decrease of Postchemotherapy Complications With the Use of Probiotics in Children With Acute Lymphoblastic Leukemia","volume":"43","year":"2021","journal-title":"J. Pediatr. Hematol.\/Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1111\/j.1365-2796.2004.01410.x","article-title":"Probiotics and Gastrointestinal Diseases","volume":"257","author":"Sullivan","year":"2005","journal-title":"J. Intern. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/MCG.0000000000001170","article-title":"Thirty Years of Lactobacillus Rhamnosus GG: A Review","volume":"53","author":"Capurso","year":"2019","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1182\/bloodadvances.2024013986","article-title":"Changes in Gut Microbiota Predict Neutropenia after Induction Treatment in Childhood Acute Lymphoblastic Leukemia","volume":"9","author":"Boulund","year":"2025","journal-title":"Blood Adv."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1093\/cid\/ciy153","article-title":"Gut Microbiome Composition Predicts Infection Risk During Chemotherapy in Children With Acute Lymphoblastic Leukemia","volume":"67","author":"Hakim","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"S364","DOI":"10.1016\/S2152-2650(24)01301-6","article-title":"CML-180 Role of Gut Microbiota in Defining the Clinical Outcomes of Patients With Chronic Myeloid Leukemia","volume":"24","author":"Fava","year":"2024","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-G\u00f3mez, L., Alcorta, A., and Abalo, R. (2023). Probiotics and Probiotic-like Agents against Chemotherapy-Induced Intestinal Mucositis: A Narrative Review. J. Pers. Med., 13.","DOI":"10.3390\/jpm13101487"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1186\/s12967-024-05232-5","article-title":"Role of Gut Microbiota in Doxorubicin-Induced Cardiotoxicity: From Pathogenesis to Related Interventions","volume":"22","author":"Huang","year":"2024","journal-title":"J. Transl. Med."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Savi, M., Bocchi, L., Bresciani, L., Falco, A., Quaini, F., Mena, P., Brighenti, F., Crozier, A., Stilli, D., and Del Rio, D. (2018). Trimethylamine-N-Oxide (TMAO)-Induced Impairment of Cardiomyocyte Function and the Protective Role of Urolithin B-Glucuronide. Molecules, 23.","DOI":"10.3390\/molecules23030549"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.cell.2016.02.011","article-title":"Gut Microbial Metabolite TMAO Enhances Platelet Hyperreactivity and Thrombosis Risk","volume":"165","author":"Zhu","year":"2016","journal-title":"Cell"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.exphem.2016.05.005","article-title":"Bortezomib for the Prevention and Treatment of Graft-versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation","volume":"44","author":"Feng","year":"2016","journal-title":"Exp. Hematol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1016\/j.chembiol.2012.08.011","article-title":"Bacterial Inactivation of the Anticancer Drug Doxorubicin","volume":"19","author":"Westman","year":"2012","journal-title":"Chem. Biol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1021\/acsinfecdis.7b00166","article-title":"Transformation of the Anticancer Drug Doxorubicin in the Human Gut Microbiome","volume":"4","author":"Yan","year":"2018","journal-title":"ACS Infect. Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1001\/archinte.162.14.1558","article-title":"Allogeneic Hematopoietic Stem Cell Transplantation: Complications and Results","volume":"162","author":"Tabbara","year":"2002","journal-title":"Arch. Intern. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"E88","DOI":"10.1002\/ajh.26077","article-title":"Fecal Microbiota Transplantation in Patients with Acute and Chronic Graft-versus-host Disease\u2014Spectrum of Responses and Safety Profile. Results from a Prospective, Multicenter Study","volume":"96","author":"Bilinski","year":"2021","journal-title":"American J. Hematol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"S40","DOI":"10.1016\/j.bbmt.2017.12.594","article-title":"Domination of the Gut Microbiota with Enterococcus Species Early after Allogeneic Bone Marrow Transplantation Is an Important Contributor to the Development of Acute Graft-Versus-Host Disease (GHVD) in Mouse and Man","volume":"24","author":"Peled","year":"2018","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/j.bbmt.2015.04.016","article-title":"Intestinal Blautia Is Associated with Reduced Death from Graft-versus-Host Disease","volume":"21","author":"Jenq","year":"2015","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2392","DOI":"10.1182\/blood.2021010719","article-title":"Alloreactive T Cells Deficient of the Short-Chain Fatty Acid Receptor GPR109A Induce Less Graft-versus-Host Disease","volume":"139","author":"Docampo","year":"2022","journal-title":"Blood"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"G1405","DOI":"10.1152\/ajpgi.00543.2011","article-title":"Butyrate Suppresses Colonic Inflammation through HDAC1-Dependent Fas Upregulation and Fas-Mediated Apoptosis of T Cells","volume":"302","author":"Zimmerman","year":"2012","journal-title":"Am. J. Physiol.-Gastrointest. Liver Physiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1038\/ni.3400","article-title":"Gut Microbiome\u2013Derived Metabolites Modulate Intestinal Epithelial Cell Damage and Mitigate Graft-versus-Host Disease","volume":"17","author":"Mathewson","year":"2016","journal-title":"Nat. Immunol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"3674","DOI":"10.1038\/s41467-018-06048-w","article-title":"Microbial Metabolite Sensor GPR43 Controls Severity of Experimental GVHD","volume":"9","author":"Fujiwara","year":"2018","journal-title":"Nat. Commun."},{"key":"ref_62","first-page":"e63995","article-title":"The Impact of Microbiome Dysbiosis on Hematopoietic Stem Cell Transplantation Outcomes: A Review Article","volume":"16","author":"Khalil","year":"2024","journal-title":"Cureus"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1016\/j.bbmt.2020.07.011","article-title":"Anaerobic Antibiotics and the Risk of Graft-versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation","volume":"26","author":"Tanaka","year":"2020","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/j.1365-2036.2007.03562.x","article-title":"Review Article: The Role of Butyrate on Colonic Function","volume":"27","author":"Hamer","year":"2008","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Sardzikova, S., Andrijkova, K., Svec, P., Beke, G., Klucar, L., Minarik, G., Bielik, V., Kolenova, A., and Soltys, K. (2023). High Diversity but Monodominance of Multidrug-Resistant Bacteria in Immunocompromised Pediatric Patients with Acute Lymphoblastic Leukemia Developing GVHD Are Not Associated with Changes in Gut Mycobiome. Antibiotics, 12.","DOI":"10.3390\/antibiotics12121667"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1038\/bmt.2017.200","article-title":"Associations between Acute Gastrointestinal GvHD and the Baseline Gut Microbiota of Allogeneic Hematopoietic Stem Cell Transplant Recipients and Donors","volume":"52","author":"Liu","year":"2017","journal-title":"Bone Marrow Transplant."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s00134-008-1002-2","article-title":"Impact of Recent Intravenous Chemotherapy on Outcome in Severe Sepsis and Septic Shock Patients with Hematological Malignancies","volume":"34","author":"Vandijck","year":"2008","journal-title":"Intensive Care Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1053\/j.gastro.2022.10.018","article-title":"Gut Microbiota Modulation of Efficacy and Toxicity of Cancer Chemotherapy and Immunotherapy","volume":"164","author":"Chrysostomou","year":"2023","journal-title":"Gastroenterology"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1111\/apt.13302","article-title":"Chemotherapy-driven Dysbiosis in the Intestinal Microbiome","volume":"42","author":"Montassier","year":"2015","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Rashidi, A., Kaiser, T., Shields-Cutler, R., Graiziger, C., Holtan, S.G., Rehman, T.U., Wasko, J., Weisdorf, D.J., Dunny, G., and Khoruts, A. (2019). Dysbiosis Patterns during Re-Induction\/Salvage versus Induction Chemotherapy for Acute Leukemia. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-42652-6"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"D\u2019Amico, F., Decembrino, N., Muratore, E., Turroni, S., Muggeo, P., Mura, R., Perruccio, K., Vitale, V., Zecca, M., and Prete, A. (2022). Oral Lactoferrin Supplementation during Induction Chemotherapy Promotes Gut Microbiome Eubiosis in Pediatric Patients with Hematologic Malignancies. Pharmaceutics, 14.","DOI":"10.3390\/pharmaceutics14081705"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e3301","DOI":"10.1002\/hon.3301","article-title":"Role of Gut Microbiome in the Outcome of Lymphoma Patients Treated with Checkpoint Inhibitors\u2014The MicroLinf Study","volume":"42","author":"Casadei","year":"2024","journal-title":"Hematol. Oncol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2409","DOI":"10.1182\/blood-2021-149881","article-title":"Comprehensive Understanding of Gut Microbiota in Treatment Na\u00efve Diffuse Large B Cell Lymphoma Patients","volume":"138","author":"Yoon","year":"2021","journal-title":"Blood"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1126\/science.aan3706","article-title":"Gut Microbiome Influences Efficacy of PD-1\u2013Based Immunotherapy against Epithelial Tumors","volume":"359","author":"Routy","year":"2018","journal-title":"Science"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Santomasso, B., Bachier, C., Westin, J., Rezvani, K., and Shpall, E.J. (2019). The Other Side of CAR T-Cell Therapy: Cytokine Release Syndrome, Neurologic Toxicity, and Financial Burden. American Society of Clinical Oncology Educational Book, American Society of Clinical Oncology.","DOI":"10.1200\/EDBK_238691"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"363","DOI":"10.5603\/AHP.a2022.0053","article-title":"Influence of Gut Microbiota on Efficacy and Adverse Effects of Treatment of Lymphoproliferative Disorders","volume":"53","author":"Zielonka","year":"2022","journal-title":"Acta Haematol. Pol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"5313","DOI":"10.1038\/s41467-022-32960-3","article-title":"CAR-T Cell Therapy-Related Cytokine Release Syndrome and Therapeutic Response Is Modulated by the Gut Microbiome in Hematologic Malignancies","volume":"13","author":"Hu","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s40425-018-0343-9","article-title":"Cytokine Release Syndrome","volume":"6","author":"Subklewe","year":"2018","journal-title":"J. Immunother. Cancer"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1038\/s41591-023-02234-6","article-title":"A Non-Antibiotic-Disrupted Gut Microbiome Is Associated with Clinical Responses to CD19-CAR-T Cell Cancer Immunotherapy","volume":"29","author":"Saini","year":"2023","journal-title":"Nat. Med."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s12276-018-0191-1","article-title":"Immune Checkpoint Inhibitors: Recent Progress and Potential Biomarkers","volume":"50","author":"Darvin","year":"2018","journal-title":"Exp. Mol. Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/bjc.2017.434","article-title":"Mechanisms of Resistance to Immune Checkpoint Inhibitors","volume":"118","author":"Jenkins","year":"2018","journal-title":"Br. J. Cancer"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1038\/s41591-019-0377-7","article-title":"The Microbiome, Cancer, and Cancer Therapy","volume":"25","author":"Helmink","year":"2019","journal-title":"Nat. Med."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1182\/blood-2009-03-206672","article-title":"PD-1\/PD-L1 Interactions Inhibit Antitumor Immune Responses in a Murine Acute Myeloid Leukemia Model","volume":"114","author":"Zhang","year":"2009","journal-title":"Blood"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1038\/s41564-020-00831-6","article-title":"Bifidobacterium Bifidum Strains Synergize with Immune Checkpoint Inhibitors to Reduce Tumour Burden in Mice","volume":"6","author":"Lee","year":"2021","journal-title":"Nat. Microbiol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"27509","DOI":"10.1073\/pnas.1921223117","article-title":"Bifidobacterium Alters the Gut Microbiota and Modulates the Functional Metabolism of T Regulatory Cells in the Context of Immune Checkpoint Blockade","volume":"117","author":"Sun","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1038\/s41408-021-00459-7","article-title":"CAR-T Cell Therapy: Current Limitations and Potential Strategies","volume":"11","author":"Sterner","year":"2021","journal-title":"Blood Cancer J."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Gamage, H.K.A.H., Venturini, C., Tetu, S.G., Kabir, M., Nayyar, V., Ginn, A.N., Roychoudhry, B., Thomas, L., Brown, M., and Holmes, A. (2021). Third Generation Cephalosporins and Piperacillin\/Tazobactam Have Distinct Impacts on the Microbiota of Critically Ill Patients. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-85946-4"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e035677","DOI":"10.1136\/bmjopen-2019-035677","article-title":"Antibiotic-Induced Changes in the Human Gut Microbiota for the Most Commonly Prescribed Antibiotics in Primary Care in the UK: A Systematic Review","volume":"10","author":"Elvers","year":"2020","journal-title":"BMJ Open"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"2767","DOI":"10.1128\/AAC.02262-13","article-title":"Alteration of the Murine Gastrointestinal Microbiota by Tigecycline Leads to Increased Susceptibility to Clostridium Difficile Infection","volume":"58","author":"Bassis","year":"2014","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"ofz252","DOI":"10.1093\/ofid\/ofz252","article-title":"Impact of Levofloxacin for the Prophylaxis of Bloodstream Infection on the Gut Microbiome in Patients with Hematologic Malignancy","volume":"6","author":"Ziegler","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"141415","DOI":"10.1016\/j.scitotenv.2020.141415","article-title":"Colistin and Amoxicillin Combinatorial Exposure Alters the Human Intestinal Microbiota and Antibiotic Resistome in the Simulated Human Intestinal Microbiota","volume":"750","author":"Li","year":"2021","journal-title":"Sci. Total Environ."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"e00479-23","DOI":"10.1128\/msphere.00479-23","article-title":"The Impact of Three Carbapenems at a Single-Day Dose on Intestinal Colonization Resistance against Carbapenem-Resistant Klebsiella Pneumoniae","volume":"8","author":"Kuang","year":"2023","journal-title":"mSphere"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/2982\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:21:42Z","timestamp":1760030502000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/2982"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,25]]},"references-count":92,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["jcm14092982"],"URL":"https:\/\/doi.org\/10.3390\/jcm14092982","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,25]]}}}