Association of intestinal permeability markers with clinical outcomes in patients undergoing allogeneic bone marrow transplantation

Abstract

Allogeneic bone marrow transplantation (allo-BMT) is a therapy that can be used in the treatment of several diseases such as hematological malignancies (leukemias and lymphomas), autoimmune diseases and hemoglobinopathies, being a potential curative therapy in several conditions. Due to its beneficial potential, there has been a significant increase in the number of allo-BMT performed annually. However, despite its potential benefits, allo-BMT is also associated with several complications, such as mortality between 10% and 14% and other complications that can significantly impact quality of life, including: 1) disease recurrence in up to 80% ; 2) graft-versus-host disease (GvHD) in up to 60%. Given the high morbidity and mortality of allo-BMT, it is necessary to investigate possible new biomarkers capable of predict the aforementioned complications. In this scenario, intestinal hiperpermeability, also known as leaky gut, has been evaluated. Previous studies have shown that, during allo-BMT, intestinal permeability can be altered by several factors, such as 1) conditioning regimen, 2) infections, and 3) intestinal dysbiosis. This increase in intestinal permeability has been associated with clinical outcomes: mortality, bacterial translocation, and GvHD. However, to date, no study has comprehensively evaluated the relationship between intestinal permeability and clinical outcomes during allo-BMT in patients in Brazil. Thus, the present study aims to explore the relationship between the intestinal permeability-clinical outcomes axis in patients undergoing allo-BMT in Brazil.